Organization
LAKELANDS ORTHOPAEDIC CLINIC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. SUSAN POORE (BILLING SUPERVISOR)
(864) 323-0527
Entity
Organization
Contact information
Practice address
103 COMMERCIAL DRIVE, ABBEVILLE, SC 29620-5593
(864) 366-8332
(864) 366-0635
Mailing address
PO BOX 3243, GREENWOOD, SC 29646-3243
(864) 229-2663
(864) 223-5694
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GP3321
—
SC
Enumeration date
04/03/2008
Last updated
04/22/2008
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