Provider Demographics
NPI:1437151990
Name:DILLE, BRICE B (MD)
Entity Type:Individual
Prefix:DR
First Name:BRICE
Middle Name:B
Last Name:DILLE
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:479 HEYWOOD AVENUE
Mailing Address - Street 2:
Mailing Address - City:SPARTANBURG
Mailing Address - State:SC
Mailing Address - Zip Code:29307-1726
Mailing Address - Country:US
Mailing Address - Phone:864-583-6381
Mailing Address - Fax:864-583-6390
Practice Address - Street 1:1520 BOILING SPRINGS RD
Practice Address - Street 2:
Practice Address - City:BOILING SPRINGS
Practice Address - State:SC
Practice Address - Zip Code:29316-5121
Practice Address - Country:US
Practice Address - Phone:864-583-6381
Practice Address - Fax:864-583-6390
Is Sole Proprietor?:No
Enumeration Date:2005-08-15
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
SC27661207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC27661OtherSC MEDICAL LICENSE
SC22N33N45OtherSC CONT. DRUG
SCCJ6730OtherRAILROAD MEDICARE GROUP
SC276613Medicaid
SCP00386245OtherRAILROAD MEDICARE INDIVID
SCBD9264792OtherDEA
SCP00386245OtherRAILROAD MEDICARE INDIVID
SCCJ6730OtherRAILROAD MEDICARE GROUP