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MARY BLACK PHYSICIANS GROUP LLC NPI 1982849519


NPI Information

NPI: 1982849519
Provider Name: MARY BLACK PHYSICIANS GROUP, LLC

Other Name: FOOTHILLS FAMILY-WESTGATE

Classification: Family Medicine - 207Q00000X
Entity Type: Organization
Address:
170 CAMELOT DR
A
SPARTANBURG, SC
ZIP 29301
Phone: (864) 576-1614
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MARY BLACK PHYSICIANS GROUP, LLC 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. MARY BLACK PHYSICIANS GROUP, LLC NPI is 1982849519. The provider is registered as an organization entity type and is a single specialty group.
The provider Other Name Is Foothills Family-westgate.

The provider's business location address is:

170 CAMELOT DR
A
SPARTANBURG, SC
ZIP 29301-650
Phone: (864) 576-1614

The provider's authorized official is Debbie Brewer .
The authorized official title is Director Provider Enrollment and has the following contact phone number (615) 465-7626.

The enumeration date for this NPI number is 12/11/2008 and was last updated on 12/11/2008.


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
18688MEDICARE PINSOUTH CAROLINA
2GP4784MEDICAIDSOUTH 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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