Individual
DR. THOMAS JUSTIN WAY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1655 E GREENVILLE ST, ANDERSON, SC 29621-2062
(864) 716-7750
(764) 716-7759
Mailing address
PO BOX 2087, ANDERSON, SC 29622-2087
(864) 716-7759
(764) 716-7759
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
35517
SC
207Y00000X
Otolaryngology Physician
N/A
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
355172
—
SC
01
—
P01224267
RR MEDICARE
SC
Enumeration date
11/03/2008
Last updated
11/14/2013
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