Provider Demographics
NPI:1467473728
Name:FAMILY PRACTICE ASSOCIATES, PA
Entity Type:Organization
Organization Name:FAMILY PRACTICE ASSOCIATES, PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MEDICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:M
Authorized Official - Last Name:KEITH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:864-427-9045
Mailing Address - Street 1:429 E MAIN ST
Mailing Address - Street 2:
Mailing Address - City:UNION
Mailing Address - State:SC
Mailing Address - Zip Code:29379-1902
Mailing Address - Country:US
Mailing Address - Phone:864-427-9045
Mailing Address - Fax:864-545-2207
Practice Address - Street 1:429 E MAIN ST
Practice Address - Street 2:
Practice Address - City:UNION
Practice Address - State:SC
Practice Address - Zip Code:29379-1902
Practice Address - Country:US
Practice Address - Phone:864-427-9045
Practice Address - Fax:864-545-2207
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-07-22
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty