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Organization
MID-CAROLINA PODIATRY, INC.
Active
Organization
MID-CAROLINA PODIATRY, INC.
Active
Other names
Lexington Foot Clinic
Organization subpart
No
Provider details
NPI number
Authorized official
PAUL R BEARDEN D.P.M. (PRESIDENT)
(803) 359-5435
Entity
Organization
Contact information
Practice address
1207 N LAKE DR, LEXINGTON, SC 29072-7647
(803) 359-5435
(803) 359-4502
Mailing address
1207 N LAKE DR, LEXINGTON, SC 29072-7647
(803) 359-5435
(803) 359-4502
Taxonomy
Speciality
Code
Description
License number
State
213ES0131X
Foot Surgery Podiatrist
00130
SC
332BC3200X
Customized Equipment (DME)
Primary
00130
SC
335E00000X
Prosthetic/Orthotic Supplier
00130
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
18003
DMERC-PAYOR NUMBER
SC
Enumeration date
08/13/2007
Last updated
04/10/2008
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