Provider Demographics
NPI:1669546487
Name:FAMILY PHYSICIANS OF GREENWOOD PA
Entity type:Organization
Organization Name:FAMILY PHYSICIANS OF GREENWOOD PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:MARK
Authorized Official - Middle Name:ALAN
Authorized Official - Last Name:BARTZ
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:864-227-3117
Mailing Address - Street 1:1506 SPRING ST
Mailing Address - Street 2:
Mailing Address - City:GREENWOOD
Mailing Address - State:SC
Mailing Address - Zip Code:29646
Mailing Address - Country:US
Mailing Address - Phone:864-227-3117
Mailing Address - Fax:864-227-1924
Practice Address - Street 1:1506 SPRING ST
Practice Address - Street 2:
Practice Address - City:GREENWOOD
Practice Address - State:SC
Practice Address - Zip Code:29646
Practice Address - Country:US
Practice Address - Phone:864-227-3117
Practice Address - Fax:864-227-1924
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-20
Last Update Date:2008-04-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCPC6837Medicaid
SC3082Medicare PIN
D05717Medicare UPIN
SCPC6837Medicaid