Provider Demographics
NPI:1134181670
Name:FLORENCE ORTHOPAEDIC ASSOCIATES PA
Entity type:Organization
Organization Name:FLORENCE ORTHOPAEDIC ASSOCIATES PA
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GEORGE
Authorized Official - Middle Name:R
Authorized Official - Last Name:DAWSON
Authorized Official - Suffix:III
Authorized Official - Credentials:MD
Authorized Official - Phone:843-662-7026
Mailing Address - Street 1:251 WEST PALMETTO ST
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:SC
Mailing Address - Zip Code:29501-4490
Mailing Address - Country:US
Mailing Address - Phone:843-662-7026
Mailing Address - Fax:843-667-9594
Practice Address - Street 1:251 WEST PALMETTO ST
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:SC
Practice Address - Zip Code:29501-4490
Practice Address - Country:US
Practice Address - Phone:843-662-7026
Practice Address - Fax:843-667-9594
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-03
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207X00000XAllopathic & Osteopathic PhysiciansOrthopaedic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCGP2737Medicaid
6545Medicare ID - Type Unspecified