Provider Demographics
NPI:1184826794
Name:ANDERSON PODIATRY ASSOCIATES PC
Entity Type:Organization
Organization Name:ANDERSON PODIATRY ASSOCIATES PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:D
Authorized Official - Last Name:HILL
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:864-225-8131
Mailing Address - Street 1:2200 NORTH MAIN STREET
Mailing Address - Street 2:
Mailing Address - City:ANDERSON
Mailing Address - State:SC
Mailing Address - Zip Code:29621
Mailing Address - Country:US
Mailing Address - Phone:864-225-8131
Mailing Address - Fax:864-225-8116
Practice Address - Street 1:2200 NORTH MAIN STREET
Practice Address - Street 2:
Practice Address - City:ANDERSON
Practice Address - State:SC
Practice Address - Zip Code:29621
Practice Address - Country:US
Practice Address - Phone:864-225-8131
Practice Address - Fax:864-225-8116
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-06-05
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCPD030213E00000X
SCPD132213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty