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Organization

SELF REGIONAL HEALTHCARE

Active
Other names
Advanced Spine and Neurosurgical Associates
Organization subpart
No

Provider details

NPI number
Authorized official
MATTHEW TOLBERT LOGAN (PRESIDENT & CEO)
(864) 725-4780
Entity
Organization

Contact information

Practice address
115 ACADEMY AVE, GREENWOOD, SC 29646-3869
(864) 725-7272
(864) 725-5799
Mailing address
104 WELLS AVE, GREENWOOD, SC 29646-3837
(864) 725-4673
(864) 725-7424

Taxonomy

Speciality
Code
Description
License number
State
207T00000X
Neurological Surgery Physician
Primary
208100000X
Physical Medicine & Rehabilitation Physician
2084A2900X
Neurocritical Care Physician
2084N0400X
Neurology Physician
332B00000X
Durable Medical Equipment & Medical Supplies
363AS0400X
Surgical Physician Assistant
363L00000X
Nurse Practitioner

Other

Enumeration date
10/17/2025
Last updated
05/15/2026
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