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Organization

ETAS CLINIC, P.C.

Active
Parent organization
ETAS CLINIC, P.C.
Other names
Etas Clinic, P.C.
Organization subpart
Yes

Provider details

NPI number
Legal business name
ETAS CLINIC, P.C.
Authorized official
EKONG I. ETA M.D. (CEO)
(864) 226-5260
Entity
Organization

Contact information

Practice address
400 N FANT ST, SUITE A, ANDERSON, SC 29621-5720
(864) 226-5260
(864) 226-5863
Mailing address
400 N FANT ST, SUITE A, ANDERSON, SC 29621-5720
(864) 226-5260
(864) 226-5863

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
21501
SC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
215011
SC
05
GP2896
SC
Enumeration date
05/07/2006
Last updated
12/04/2007
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