Individual
THOMAS JOHNSTON PATRICK JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
184 OAKLAND AVE, SPARTANBURG, SC 29302-1669
(864) 582-8570
(864) 585-3528
Mailing address
184 OAKLAND AVE, SPARTANBURG, SC 29302-1669
(864) 582-8570
(864) 585-3528
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
72
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P00315353
RAILROAD MEDICARE PROV #
SC
05
—
PD0724
—
SC
Enumeration date
07/21/2006
Last updated
07/08/2007
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