Individual
DR. JOHN WESLEY WOMACK III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
35 INTERNATIONAL DR, GREENVILLE, SC 29615-4816
(864) 234-7654
(864) 675-1657
Mailing address
35 INTERNATIONAL DR, GREENVILLE, SC 29615-4816
(864) 234-7654
(864) 675-1657
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
30619
SC
207XX0004X
Orthopaedic Foot and Ankle Surgery Physician
Primary
30619
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
306190
—
SC
01
—
8157
MEDICARE PTAN
SC
Enumeration date
02/27/2007
Last updated
09/16/2013
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