Provider Demographics
NPI:1902849920
Name:GETTYS, RICHARD HENRY JR (MD)
Entity Type:Individual
Prefix:
First Name:RICHARD
Middle Name:HENRY
Last Name:GETTYS
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1 INDEPENDENCE PT STE 212
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29615-4536
Mailing Address - Country:US
Mailing Address - Phone:864-797-6303
Mailing Address - Fax:
Practice Address - Street 1:325 MEDICAL PKWY
Practice Address - Street 2:SUITE 250
Practice Address - City:GREER
Practice Address - State:SC
Practice Address - Zip Code:29650-2457
Practice Address - Country:US
Practice Address - Phone:864-797-9400
Practice Address - Fax:864-797-9402
Is Sole Proprietor?:No
Enumeration Date:2006-06-14
Last Update Date:2018-01-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC13304208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC133046Medicaid
SCP00823472OtherRR MEDICARE
SC133046Medicaid
SCB91832Medicare UPIN
SCP00823472OtherRR MEDICARE