MEDICARE: GREENVILLE PODIATRY ASSOCIATES PA

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
1	213E00000X	Podiatrist

General Provider Information

NPI Number	:	1982632931
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	GREENVILLE PODIATRY ASSOCIATES PA

Provider Business Mailing Address
First Line	:	5 ARBORLAND WAY
Second Line	:
City	:	GREENVILLE
State	:	SC
Zip	:	29615-2201
Country	:	US
Telephone Number	:	864-234-7370
Fax Number	:	864-234-0779

Provider Business Practice Location Address
First Line	:	5 ARBORLAND WAY
Second Line	:
City	:	GREENVILLE
State	:	SC
Zip	:	29615-2201
Country	:	US
Telephone Number	:	864-234-7370
Fax Number	:	864-234-0779

Authorized Official
Title or Position	:	PRESIDENT
Name	:	DR. THOMAS MICHAEL JONES
Credential	:	DPM
Telephone Number	:	864-234-7370

Provider Enumeration Date	:	06/29/2006
Last Update Date	:	08/22/2020

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