Full Name | |
---|---|
Speciality | Family Medicine |
Location | 109 Buford Ave, Anderson, South Carolina |
Authorized Official Name and Position | Stephen Ford Worsham (OWNER) |
Authorized Official Contact | 8642241316 |
Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
Mailing Address | Practice Location Address |
---|---|
109 Buford Ave Anderson SC 29621 Ph: (864) 224-1316 | 109 Buford Ave Anderson SC 29621 Ph: (864) 224-1316 |
NPI Number | 1619022662 |
---|---|
Provider Enumeration Date | 01/23/2007 |
Last Update Date | 11/28/2007 |
Medicare PECOS PAC ID | 6002898053 |
---|---|
Medicare Enrollment ID | O20040603000329 |
Identifier | Type | State | Issuer |
---|---|---|---|
1619022662 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
---|---|---|---|
207Q00000X | Family Medicine | 16215 (South Carolina) | Primary |
Provider Name | Stephen F Worsham |
---|---|
Provider Type | Practitioner - Family Practice |
Provider Identifiers | NPI Number: 1750565784 PECOS PAC ID: 4082696133 Enrollment ID: I20040603000255 |
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