| NPI | 1447619218 |
|---|---|
| Entity Type | Organization |
| Authorized Contact | OLIVER POPE SIMMONS Owner 803-421-9208 |
| Organization Subpart ? | No |
| Primary Taxonomy | 2086S0122X Surgery, Plastic and Reconstructive Surgery (Licence: SC 33186) |
| Additional Taxonomies | 207YX0905X Otolaryngology, Otolaryngology/Facial Plastic Surgery (Licence: SC 33186) |
| 2086S0105X Surgery, Surgery of the Hand (Licence: SC 33186) | |
| 207ND0101X Dermatology, MOHS-Micrographic Surgery (Licence: SC 33186) | |
| 207YX0602X Otolaryngology, Otolaryngic Allergy (Licence: SC 33186) | |
| 208200000X Plastic Surgery (Licence: SC 33186) | |
| Enumeration Date | 2016-02-22 |
| Last Update Date | 2017-01-13 |