Organization
FOOTHILLS E.N.T., PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ROBERT C. WATERS M.D. (PRESIDENT)
(864) 859-1912
Entity
Organization
Contact information
Practice address
201 RICHARD ST, EASLEY, SC 29640-1442
(864) 859-1912
(864) 855-9836
Mailing address
201 RICHARD ST, EASLEY, SC 29640-1442
(864) 859-1912
(864) 855-9836
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GP0411
—
SC
Enumeration date
05/09/2006
Last updated
12/21/2007
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