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NPI Code Detail

MEDICARE: GREENWOOD UROLOGICAL P.A.

MEDICARE: GREENWOOD UROLOGICAL P.A.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208800000XUrology PhysicianSC

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1649273749
Entity Type Code : Organization
Provider Name (Legal Business Name) : GREENWOOD UROLOGICAL P.A.
Provider Business Mailing Address
First Line : 109 LINER DRIVE
Second Line :
City : GREENWOOD
State : SC
Zip : 29646
Country : US
Telephone Number : 800-922-4194
Fax Number :
Provider Business Practice Location Address
First Line : 109 LINER DR
Second Line :
City : GREENWOOD
State : SC
Zip : 29646-2311
Country : US
Telephone Number : 800-922-4194
Fax Number :
Authorized Official
Title or Position : ADMINISTRATOR
Name : MRS. CLAUDIA E. KING
Credential :
Telephone Number : 800-922-4794
Provider Enumeration Date : 05/23/2005
Last Update Date : 01/19/2015

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Directions to “GREENWOOD UROLOGICAL P.A. ” Practice Location

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