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Individual

STEPHEN NIX

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
C-AA

Contact information

Practice address
101 E WOOD ST, SPARTANBURG, SC 29303-3040
(864) 560-6952
Mailing address
PO BOX 743070, ATTN: CREDENTIALING DEPT, BUILDING F, SUITE 100, ATLANTA, GA 30374-3070

Taxonomy

Speciality
Code
Description
License number
State
367H00000X
Anesthesiologist Assistant
Primary
141
SC
367H00000X
Anesthesiologist Assistant
3700
GA

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
100000710A
GA
05
100000710B
GA
05
100000710C
GA
Enumeration date
10/03/2005
Last updated
09/10/2025
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