Provider Demographics
NPI:1851389142
Name:FAMILY PHYSICIANS OF BOILING SPRINGS
Entity Type:Organization
Organization Name:FAMILY PHYSICIANS OF BOILING SPRINGS
Other - Org Name:SPARTANBURG REGIONAL HEALTHCARE SYSTEM
Other - Org Type:Other Name
Authorized Official - Title/Position:M.D
Authorized Official - Prefix:DR
Authorized Official - First Name:JENNIFER
Authorized Official - Middle Name:G
Authorized Official - Last Name:BAUGH
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:864-560-3650
Mailing Address - Street 1:3941 HIGHWAY 9
Mailing Address - Street 2:
Mailing Address - City:BOILING SPRINGS
Mailing Address - State:SC
Mailing Address - Zip Code:29316-8578
Mailing Address - Country:US
Mailing Address - Phone:864-560-3650
Mailing Address - Fax:864-560-3675
Practice Address - Street 1:3941 HIGHWAY 9
Practice Address - Street 2:
Practice Address - City:BOILING SPRINGS
Practice Address - State:SC
Practice Address - Zip Code:29316-8578
Practice Address - Country:US
Practice Address - Phone:864-560-3650
Practice Address - Fax:864-560-3675
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2005-10-11
Last Update Date:2008-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCSC20281207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCG89723Medicare UPIN