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Organization

OCONEE PHYSICIAN PRACTICES

Active
Other names
Upstate Family Medicine
Organization subpart
No

Provider details

NPI number
Authorized official
MR. MATTHEW G HEDTKE (EXECUTIVE DIRECTOR)
(864) 885-7989
Entity
Organization

Contact information

Practice address
109 OMNI DR, SENECA, SC 29672-9448
(864) 882-6141
(864) 882-6680
Mailing address
301 MEMORIAL DR STE G, SENECA, SC 29672-9445
(864) 885-7989
(864) 885-7945

Taxonomy

Speciality
Code
Description
License number
State
261QR1300X
Rural Health Clinic/Center
Primary
SC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
GP4697
SC
Enumeration date
01/22/2008
Last updated
01/22/2008
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