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Organization
SPECIALTY ORTHOPAEDICS AND SPORTS MEDICINE, LLC
Active
Organization
SPECIALTY ORTHOPAEDICS AND SPORTS MEDICINE, LLC
Active
Other names
SpecOrtho
Organization subpart
No
Provider details
NPI number
Authorized official
DR. GLEN T FELTHAM M.D. (OWNER, PHYSICIAN)
(570) 452-0097
Entity
Organization
Contact information
Practice address
130 CRISANTO AVENUE, SUITE B, FORT MILL, SC 29715
(803) 548-6464
(803) 396-8440
Mailing address
130 CRISANTO AVENUE, SUITE B, FORT MILL, SC 29715
(803) 548-6464
(803) 396-8440
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
—
—
207XX0005X
Sports Medicine (Orthopaedic Surgery) Physician
—
—
213E00000X
Podiatrist
—
—
213ES0103X
Foot & Ankle Surgery Podiatrist
—
—
363A00000X
Physician Assistant
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
G842
—
SC
Enumeration date
04/27/2017
Last updated
07/24/2026
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