Provider Demographics
NPI:1932144482
Name:ROCK HILL GYNECOLOGICAL AND OBSTETRICAL ASSOCIATES, PA
Entity Type:Organization
Organization Name:ROCK HILL GYNECOLOGICAL AND OBSTETRICAL ASSOCIATES, PA
Other - Org Name:FORT MILL GYNECOLOGICAL AND OBSTETRICAL ASSOCIATES
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:ROY
Authorized Official - Middle Name:NORMAN
Authorized Official - Last Name:TAYLOR
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:803-328-2401
Mailing Address - Street 1:1721 EBENEZER RD
Mailing Address - Street 2:SUITE 145
Mailing Address - City:ROCK HILL
Mailing Address - State:SC
Mailing Address - Zip Code:29732-4103
Mailing Address - Country:US
Mailing Address - Phone:803-328-2401
Mailing Address - Fax:803-328-1030
Practice Address - Street 1:1721 EBENEZER RD
Practice Address - Street 2:SUITE 145
Practice Address - City:ROCK HILL
Practice Address - State:SC
Practice Address - Zip Code:29732-4103
Practice Address - Country:US
Practice Address - Phone:803-328-2401
Practice Address - Fax:803-328-1030
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-18
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC13792207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC1467Medicare ID - Type Unspecified