Provider Demographics
NPI:1023069234
Name:PARIS VIEW FAMILY PRACTICE PA
Entity type:Organization
Organization Name:PARIS VIEW FAMILY PRACTICE PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT / OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:CAROLYN
Authorized Official - Middle Name:D
Authorized Official - Last Name:FIELDS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:864-271-1464
Mailing Address - Street 1:1028 N CHURCH ST
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29601-1639
Mailing Address - Country:US
Mailing Address - Phone:864-271-1464
Mailing Address - Fax:864-467-9119
Practice Address - Street 1:1028 N CHURCH ST
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29601-1639
Practice Address - Country:US
Practice Address - Phone:864-271-1464
Practice Address - Fax:864-467-9119
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-05-12
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC302F00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes302F00000XManaged Care OrganizationsExclusive Provider Organization
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCGP2375Medicaid
SCGP2375Medicaid