Provider Demographics
NPI:1396221248
Name:ST. FRANCIS PHYSICIAN SERVICES, INC
Entity Type:Organization
Organization Name:ST. FRANCIS PHYSICIAN SERVICES, INC
Other - Org Name:BON SECOURS UROGYNECOLOGY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:CFO
Authorized Official - Prefix:
Authorized Official - First Name:WILBUR
Authorized Official - Middle Name:
Authorized Official - Last Name:GAY
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:864-255-1904
Mailing Address - Street 1:PO BOX 743294
Mailing Address - Street 2:
Mailing Address - City:ATLANTA
Mailing Address - State:GA
Mailing Address - Zip Code:30374-3294
Mailing Address - Country:US
Mailing Address - Phone:864-605-3721
Mailing Address - Fax:864-605-3587
Practice Address - Street 1:2 INNOVATION DR STE 180
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29607-5265
Practice Address - Country:US
Practice Address - Phone:864-605-3104
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:ST. FRANCIS PHYSICIAN SERVICES, INC
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2018-07-13
Last Update Date:2019-06-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207VF0040XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyFemale Pelvic Medicine and Reconstructive SurgeryGroup - Multi-Specialty