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WELLNESS FAMILY MEDICINE NPI 1063445971


NPI Information

NPI: 1063445971
Provider Name: WELLNESS FAMILY MEDICINE

Other Name: UPSTATE OCCUPATIONAL MEDICINE

Classification: Family Medicine - 207Q00000X
Entity Type: Organization

CLIA Number: 42D0967663

Address:
1241 BOILING SPRINGS RD
SPARTANBURG, SC
ZIP 29303
Phone: (864) 591-0992
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WELLNESS FAMILY MEDICINE is a family medicine in Spartanburg, SC. The provider is family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine is not limited by age, sex, organ system, or disease entity. WELLNESS FAMILY MEDICINE NPI is 1063445971. The provider is registered as an organization entity type and is a single specialty group.
The provider Other Name Is Upstate Occupational Medicine.

The provider's business location address is:

1241 BOILING SPRINGS RD
SPARTANBURG, SC
ZIP 29303-258
Phone: (864) 591-0992
Fax: (864) 591-0776

The provider's authorized official is Ira Gordon Early .
The authorized official title is President and has the following contact phone number (864) 591-0992.

The CLIA number assigned to this NPI record is 42D0967663 - physician office with a certificate type of Certificate of Waiver.

The enumeration date for this NPI number is 7/7/2006 and was last updated on 8/22/2020.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
1207Q00000XFamily MedicineYes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.Other Provider IdentifierOther Provider Identifier TypeOther Provider Identifier StateOther Provider Identifier Issuer
1GP2944MEDICAIDSOUTH CAROLINA

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

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