Provider Demographics
NPI:1205098571
Name:FLORENCE ORTHOPEDIC ASSOCIATES PA
Entity type:Organization
Organization Name:FLORENCE ORTHOPEDIC ASSOCIATES PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
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 W PALMETTO ST
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:SC
Mailing Address - Zip Code:29501-4415
Mailing Address - Country:US
Mailing Address - Phone:843-662-7026
Mailing Address - Fax:843-667-9594
Practice Address - Street 1:251 W PALMETTO ST
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:SC
Practice Address - Zip Code:29501-4415
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:2008-06-27
Last Update Date:2008-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC5690332B00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332B00000XSuppliersDurable Medical Equipment & Medical Supplies
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCDE1553Medicaid
SC0465510002Medicare NSC