Provider Demographics
NPI:1750444568
Name:OBGYN SOCIETY OF SPARTANBURG, INC.
Entity Type:Organization
Organization Name:OBGYN SOCIETY OF SPARTANBURG, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:GENERAL PARTNER
Authorized Official - Prefix:DR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:WATKINS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:864-560-6163
Mailing Address - Street 1:100 E WOOD ST
Mailing Address - Street 2:SUITE 202
Mailing Address - City:SPARTANBURG
Mailing Address - State:SC
Mailing Address - Zip Code:29303-3004
Mailing Address - Country:US
Mailing Address - Phone:864-560-6163
Mailing Address - Fax:864-560-7092
Practice Address - Street 1:100 E WOOD ST
Practice Address - Street 2:SUITE 202
Practice Address - City:SPARTANBURG
Practice Address - State:SC
Practice Address - Zip Code:29303-3004
Practice Address - Country:US
Practice Address - Phone:864-560-6163
Practice Address - Fax:864-560-7092
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-12-19
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Multi-Specialty