Organization
SPARTANBURG EAR NOSE & THROAT, HEAD & NECK SURGERY PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. ALLISON RODGERS (HUMAN RESOURCES)
(864) 582-2900
Entity
Organization
Contact information
Practice address
1095 IRON ORE ROAD, SPARTANBURG, SC 29303-2239
(864) 582-2900
(864) 582-4991
Mailing address
P.O. BOX 5787, SPARTANBURG, SC 29304-5787
(864) 582-2900
(864) 582-4991
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
CB3406
RAILROAD MEDICARE
SC
05
—
PA0828
—
SC
Enumeration date
05/19/2006
Last updated
10/24/2023
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