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Individual

DR. JOHN FITZGERALD ANSLEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
832 COOK RD, ORANGEBURG, SC 29118-2126
(803) 536-5511
(803) 536-0636
Mailing address
832 COOK RD, ORANGEBURG, SC 29118-2126
(803) 536-5511
(803) 536-0636

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
21712
SC
207Y00000X
Otolaryngology Physician
Primary
21712
SC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
PA2835
SC
Enumeration date
05/04/2006
Last updated
07/09/2020
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