Individual
JOHN THOMPSON TATE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1690 SKYLYN DR, SUITE 140, SPARTANBURG, SC 29307-1022
(864) 591-1664
(864) 577-0620
Mailing address
1 INDEPENDENCE PT, SUITE 212, GREENVILLE, SC 29615-4545
(864) 797-6044
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
9463
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
576007863153
BCBS OF SC
SC
05
—
94631
—
SC
01
—
P00682161
RR MEDICARE
SC
Enumeration date
05/27/2006
Last updated
09/04/2013
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