Doctor Name: | WILLIAM SEAN IRVIN |
NPI Number: | 1114938768 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | PAC |
License Number: | 153 |
Business Practice Address: | 112 John St Suite 201 Easley, SC - 296401472 |
Business Phone Number: | 8648502663 |
Business Fax Number: | 8643060012 |
Mailing Address: | Po Box 2089, EASLEY |
State: | SC |
Postal Code: | 296412089 |
Phone Number: | 8648502663 |
Fax Number: | 8648559577 |
NPI Enumeration Date: | 08/10/2006 |
NPI Last Update Date: | 01/28/2013 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 363AS0400X |
License Number: | 153 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | SC |
Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
Taxonomy Classification: | Physician Assistant |
Taxonomy Specialization: | Surgical |
Taxonomy Definition: |