Individual
DR. JOHN B EBERLY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
4501 OLD SPARTANBURG RD, TAYLORS, SC 29687-4105
(864) 268-1119
(864) 268-1714
Mailing address
4501 OLD SPARTANBURG RD, TAYLORS, SC 29687-4105
(864) 268-1119
(864) 268-1714
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
14967
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0103038
CAROLINA CARE PLAN
SC
01
—
1035477
UNITED HEALTH CARE
SC
05
—
149672
—
SC
01
—
49218
MEDCOST
SC
01
—
57-0947101
TAX ID
SC
Enumeration date
05/27/2005
Last updated
06/24/2015
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