| Upstate Occupational Medicine | |
|
1241 Boiling Springs Rd Spartanburg SC 29303-2258 | |
| (864) 591-0992 | |
| (864) 591-0776 |
| Full Name | Upstate Occupational Medicine |
|---|---|
| Speciality | Family Medicine |
| Location | 1241 Boiling Springs Rd, Spartanburg, South Carolina |
| Authorized Official Name and Position | Ira Gordon Early (PRESIDENT) |
| Authorized Official Contact | 8645910992 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Upstate Occupational Medicine 1241 Boiling Springs Rd Spartanburg SC 29303-2258 Ph: (864) 591-0992 | Upstate Occupational Medicine 1241 Boiling Springs Rd Spartanburg SC 29303-2258 Ph: (864) 591-0992 |
| NPI Number | 1063445971 |
|---|---|
| Provider Enumeration Date | 07/07/2006 |
| Last Update Date | 08/22/2020 |
| Medicare PECOS PAC ID | 3476517244 |
|---|---|
| Medicare Enrollment ID | O20041112000423 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1063445971 | NPI | - | NPPES |
| GP2944 | Medicaid | SC |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Primary |
| Provider Name | Ira G Early |
|---|---|
| Provider Type | Practitioner - Preventive Medicine |
| Provider Identifiers | NPI Number: 1144218876 PECOS PAC ID: 4284698051 Enrollment ID: I20041112000447 |
| Provider Name | Betty J Abernathy |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1306827431 PECOS PAC ID: 7416911292 Enrollment ID: I20041112000470 |
| Provider Name | Amber Bullard |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1023694163 PECOS PAC ID: 2264839869 Enrollment ID: I20210924000429 |
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