Individual
DR. JOHN L EADY
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2 MEDICAL PARK RD, SUITE 404, COLUMBIA, SC 29203-6808
(803) 434-6812
(803) 255-3451
Mailing address
15 MEDICAL PARK RD, SUITE 300, COLUMBIA, SC 29203-8003
(803) 255-3417
(803) 255-3451
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
5196
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
051963
—
SC
Enumeration date
04/13/2006
Last updated
07/08/2007
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