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NPI Code Detail

MEDICARE: ORTHOPEDIC SPECIALTIES OF SPARTANBURG,PC

MEDICARE: ORTHOPEDIC SPECIALTIES OF SPARTANBURG,PC
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
1204C00000XSports Medicine (Neuromusculoskeletal Medicine) Physician6848SC

General Provider Information

NPI Number : 1811947518
Entity Type Code : Organization
Provider Name (Legal Business Name) : ORTHOPEDIC SPECIALTIES OF SPARTANBURG,PC
Provider Business Mailing Address
First Line : 303 E WOOD ST
Second Line :
City : SPARTANBURG
State : SC
Zip : 29303-3020
Country : US
Telephone Number : 864-560-4567
Fax Number : 864-560-4568
Provider Business Practice Location Address
First Line : 303 E WOOD ST
Second Line :
City : SPARTANBURG
State : SC
Zip : 29303-3020
Country : US
Telephone Number : 864-560-4567
Fax Number : 864-560-4568
Authorized Official
Title or Position : ADMINISTRATOR
Name : MR. PETE BUCHANAN
Credential :
Telephone Number : 864-560-4567
Provider Enumeration Date : 05/11/2006
Last Update Date : 08/22/2020

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Directions to “ORTHOPEDIC SPECIALTIES OF SPARTANBURG,PC ” Practice Location

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