Organization
SPARTANBURG REGIONAL MED CTR
Active
Parent organization
SPARTANBURG REGIONAL HEALTH SERVICES DISTRICTS, INC
Other names
Magnolia Plastic Surgery-Rocky Slope
Organization subpart
Yes
Provider details
NPI number
Legal business name
SPARTANBURG REGIONAL HEALTH SERVICES DISTRICTS, INC
Authorized official
MARK AYCOCK (EXECUTIVE VICE PRESIDENT)
(864) 560-6000
Entity
Organization
Contact information
Practice address
29 ROCKY SLOPE RD, GREENVILLE, SC 29607-3909
(864) 286-9229
(864) 286-9228
Mailing address
PO BOX 2168, SPARTANBURG, SC 29304-2168
(864) 560-4304
(864) 560-4413
Taxonomy
Speciality
Code
Description
License number
State
208200000X
Plastic Surgery Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GP1118
—
SC
Enumeration date
04/07/2011
Last updated
05/19/2011
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