Provider Demographics
NPI:1821283268
Name:MCCAIN ORTHOPAEDIC CLINIC
Entity Type:Organization
Organization Name:MCCAIN ORTHOPAEDIC CLINIC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/DOCTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:RICHARD
Authorized Official - Middle Name:S
Authorized Official - Last Name:MCCAIN
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:803-254-8800
Mailing Address - Street 1:1518 PICKENS ST
Mailing Address - Street 2:
Mailing Address - City:COLUMBIA
Mailing Address - State:SC
Mailing Address - Zip Code:29201-3449
Mailing Address - Country:US
Mailing Address - Phone:803-254-8800
Mailing Address - Fax:803-254-9130
Practice Address - Street 1:1518 PICKENS ST
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29201-3449
Practice Address - Country:US
Practice Address - Phone:803-254-8800
Practice Address - Fax:803-254-9130
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-09-10
Last Update Date:2023-10-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC9517174400000X
207X00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
No174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC200027758OtherRAILROAD MEDICARE
SCGP0450Medicaid
SC2797Medicare PIN
SC200027758OtherRAILROAD MEDICARE