Organization
FOOTHILLS ANESTHESIA CONSULTANTS, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
URSULA LONG MD (AUTHORIZED REP.)
(864) 560-6122
Entity
Organization
Contact information
Practice address
101 E WOOD ST, SPARTANBURG, SC 29303-3040
(864) 560-6122
(864) 560-6276
Mailing address
804 SCOTT NIXON MEMORIAL DR, AUGUSTA, GA 30907-2464
(864) 560-6122
(864) 560-6276
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
—
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GP0770
—
SC
Enumeration date
09/29/2005
Last updated
08/22/2020
Update your record
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