Organization Name: | R. DALE PADGETT, MD,PA NEW CORP |
NPI Number: | 1992838197 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | RONALD D PADGETT (MD) |
Mailing Address: | 526 North St Bamberg |
State: | SC US |
Postal Code: | 290031319 |
Phone Number: | 8032452433 |
Fax Number: | 8032457424 |
NPI Enumeration Date: | 03/14/2007 |
NPI Last Update Date: | 04/17/2015 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | 10332 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | SC |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |