Organization
GATEWAY CHILDREN'S
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TONYA KNOX-FRAZIER MD (CEO)
(864) 406-6041
Entity
Organization
Contact information
Practice address
397 SERPENTINE DR, STE B, SPARTANBURG, SC 29303-3067
(864) 406-6041
(864) 406-6042
Mailing address
2153 E MAIN ST, STE C14-321, DUNCAN, SC 29334-8724
(864) 406-6041
(864) 433-0119
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
Primary
27451
SC
208000000X
Pediatrics Physician
27451
SC
2084P0804X
Child & Adolescent Psychiatry Physician
27451
SC
Other
Enumeration date
08/28/2015
Last updated
08/28/2015
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