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Organization

UPSTATE PATHOLOGY, PA

Active
Organization subpart
No

Provider details

NPI number
Authorized official
JOHN THOMAS LATHAM JR. MD (PATHOLOGIST)
(864) 322-4167
Entity
Organization

Contact information

Practice address
1 SAINT FRANCIS DR, GREENVILLE, SC 29601-3955
(864) 322-4167
Mailing address
PO BOX 9280, GREENVILLE, SC 29604-9280

Taxonomy

Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
GP0741
SC
Enumeration date
09/28/2007
Last updated
10/16/2007
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