Individual
WILLIAM TRAVIS WEATHERS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1650 SKYN DRIVE, SUITE 240, SPARTANBURG, SC 29307-1069
(864) 598-0460
(864) 596-5164
Mailing address
1 INDEPENDENCE PT, SUITE 212, GREENVILLE, SC 29615-4545
(864) 797-6044
Taxonomy
Speciality
Code
Description
License number
State
208000000X
Pediatrics Physician
Primary
5116
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
051160
—
SC
01
—
576007863032
BCBS OF SC ID
SC
01
—
6356292
CIGNA ID
SC
Enumeration date
06/09/2006
Last updated
11/24/2014
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