Provider Demographics
NPI:1235447145
Name:BAPTIST EASLEY
Entity Type:Organization
Organization Name:BAPTIST EASLEY
Other - Org Name:UPSTATE BONE AND JOINT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARY BETHE
Authorized Official - Middle Name:
Authorized Official - Last Name:ROCHELLE
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:864-855-5104
Mailing Address - Street 1:PO BOX 2089
Mailing Address - Street 2:
Mailing Address - City:EASLEY
Mailing Address - State:SC
Mailing Address - Zip Code:29641-2089
Mailing Address - Country:US
Mailing Address - Phone:864-855-5104
Mailing Address - Fax:864-859-9362
Practice Address - Street 1:112 JOHN ST
Practice Address - Street 2:STE 201
Practice Address - City:EASLEY
Practice Address - State:SC
Practice Address - Zip Code:29640-1472
Practice Address - Country:US
Practice Address - Phone:864-855-5104
Practice Address - Fax:864-859-9362
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-09-14
Last Update Date:2010-09-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Multi-Specialty