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NPI Code Detail

MEDICARE: DR. CHARLES W OUTZ JR. MD

MEDICARE: DR. CHARLES W OUTZ JR. MD
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
1207P00000XEmergency Medicine Physician23843SC
2208D00000XGeneral Practice Physician23843SC

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 : 1962472084
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. CHARLES W OUTZ JR. MD
Provider Business Mailing Address
First Line : PO BOX 447
Second Line :
City : EASLEY
State : SC
Zip : 29641-0447
Country : US
Telephone Number : 864-220-0103
Fax Number : 864-220-9925
Provider Business Practice Location Address
First Line : 3150 HIGHWAY 153
Second Line :
City : PIEDMONT
State : SC
Zip : 29673-9498
Country : US
Telephone Number : 864-220-0103
Fax Number : 864-220-9925
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/23/2006
Last Update Date : 03/28/2022

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