Provider Demographics
NPI:1619273802
Name:PEE DEE ORTHOPEDIC ASSOC
Entity Type:Organization
Organization Name:PEE DEE ORTHOPEDIC ASSOC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PARTNER
Authorized Official - Prefix:
Authorized Official - First Name:WILLIE
Authorized Official - Middle Name:S
Authorized Official - Last Name:EDWARDS
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:843-662-5233
Mailing Address - Street 1:901 E CHEVES ST
Mailing Address - Street 2:SUITE 100
Mailing Address - City:FLORENCE
Mailing Address - State:SC
Mailing Address - Zip Code:29506-2716
Mailing Address - Country:US
Mailing Address - Phone:843-662-5233
Mailing Address - Fax:843-678-9003
Practice Address - Street 1:1604 MEDICAL DR
Practice Address - Street 2:
Practice Address - City:LAURINBURG
Practice Address - State:NC
Practice Address - Zip Code:28352-5524
Practice Address - Country:US
Practice Address - Phone:910-276-4611
Practice Address - Fax:910-277-4244
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:PEE DEE ORTHOPAEDIC ASSOCIATES, P.A.
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-02-04
Last Update Date:2011-04-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty