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800 University Way Gb Hodge Center Spartanburg SC 29303-4932 | |
(864) 503-5104 | |
(972) 367-3451 |
Full Name | |
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Speciality | Family Medicine |
Location | 800 University Way, Spartanburg, South Carolina |
Authorized Official Name and Position | Mouzon Bass (AGENT) |
Authorized Official Contact | 18005559073 |
Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
Mailing Address | Practice Location Address |
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5050 Spring Valley Rd Dallas TX 75244-3995 Ph: (800) 555-9073 | 800 University Way Gb Hodge Center Spartanburg SC 29303-4932 Ph: (864) 503-5104 |
NPI Number | 1306235999 |
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Provider Enumeration Date | 01/20/2015 |
Last Update Date | 01/20/2015 |
Identifier | Type | State | Issuer |
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1306235999 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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207Q00000X | Family Medicine | (* (Not Available)) | Primary |
207QS0010X | Family Medicine - Sports Medicine | (* (Not Available)) | Secondary |
Academic Primary Care Associates Primary Care Clinic Medicare: Not Enrolled in Medicare Practice Location: 410 Magnolia St, Spartanburg, SC 29303 Phone: 540-443-7180 | |