Provider Demographics
NPI:1316370646
Name:ROPER SAINT FRANCIS PHYSICIANS NETWORK
Entity Type:Organization
Organization Name:ROPER SAINT FRANCIS PHYSICIANS NETWORK
Other - Org Name:ROPER ST. FRANCIS PHYSICIAN PARTNERS NEUROSURGERY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:VICE PRESIDENT
Authorized Official - Prefix:MR
Authorized Official - First Name:DOUGLAS
Authorized Official - Middle Name:
Authorized Official - Last Name:BOWLING
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:843-724-2846
Mailing Address - Street 1:PO BOX 751649
Mailing Address - Street 2:
Mailing Address - City:CHARLOTTE
Mailing Address - State:NC
Mailing Address - Zip Code:28275-1649
Mailing Address - Country:US
Mailing Address - Phone:843-789-1620
Mailing Address - Fax:843-724-2440
Practice Address - Street 1:2085 HENRY TECKLENBURG DR
Practice Address - Street 2:SUITE 320
Practice Address - City:CHARLESTON
Practice Address - State:SC
Practice Address - Zip Code:29414-7710
Practice Address - Country:US
Practice Address - Phone:843-723-8967
Practice Address - Fax:843-577-6093
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-08-09
Last Update Date:2017-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological SurgeryGroup - Multi-Specialty