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Organization
NEWBERRY PATHOLOGY ASSOCIATES PA
Active
Organization
NEWBERRY PATHOLOGY ASSOCIATES PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. FRANCES S PUCKETT (PRESIDENT/FINANCIAL DIRECTOR)
(864) 223-3070
Entity
Organization
Contact information
Practice address
2669 KINARD ST, NEWBERRY, SC 29108-2911
(888) 446-9898
(803) 276-5521
Mailing address
PO BOX 49009, GREENWOOD, SC 29649-0001
(864) 223-3070
(864) 223-1396
Taxonomy
Speciality
Code
Description
License number
State
207ZF0201X
Forensic Pathology Physician
5559
SC
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
5559
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
42D0248801
CLIA REGISTRATION#
—
01
—
CG8639
RAILROAD MEDICARE
—
05
—
GP1437
—
SC
Enumeration date
04/12/2006
Last updated
12/15/2014
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