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Organization

DERMATOLOGY HOUSE CALLS LLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DAVID HAYNIE FANT JR. (PRACTICE MANAGER)
(864) 365-6291
Entity
Organization

Contact information

Practice address
821 N MAIN ST STE 12, ANDERSON, SC 29621-5544
(864) 365-6405
(833) 471-5951
Mailing address
821 N MAIN ST STE 12, ANDERSON, SC 29621-5544
(864) 365-6405
(833) 471-5951

Taxonomy

Speciality
Code
Description
License number
State
207N00000X
Dermatology Physician
Primary
207P00000X
Emergency Medicine Physician
363L00000X
Nurse Practitioner
363LA2200X
Adult Health Nurse Practitioner

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
PG1499
SC
Enumeration date
02/09/2023
Last updated
12/08/2025
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