Organization
AIKEN PROFESSIONAL ASSOCIATION, LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
TODD EVANS (CFO)
(610) 382-4334
Entity
Organization
Contact information
Practice address
420 SOCIETY HILL DR STE 200, AIKEN, SC 29803-1731
(803) 649-7266
Mailing address
367 S GULPH RD, KING OF PRUSSIA, PA 19406-3121
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
—
SC
207R00000X
Internal Medicine Physician
Primary
—
SC
207RC0000X
Cardiovascular Disease Physician
—
—
207RG0100X
Gastroenterology Physician
—
SC
207RI0011X
Interventional Cardiology Physician
—
—
207V00000X
Obstetrics & Gynecology Physician
—
—
207X00000X
Orthopaedic Surgery Physician
—
—
208600000X
Surgery Physician
—
SC
208800000X
Urology Physician
—
—
208G00000X
Thoracic Surgery (Cardiothoracic Vascular Surgery) Physician
—
—
363L00000X
Nurse Practitioner
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1639479801
BCBS SC
SC
01
—
DR4297
RAILROAD MEDICARE
SC
05
—
GP5588
—
SC
Enumeration date
10/22/2010
Last updated
06/26/2019
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