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Contact Information

EASLEY PEDIATRICS PA
800 NORTH A ST
EASLEY, SC29640
 Phone: 864-855-0001
 Fax: 864-855-5030
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Pediatrics

208000000X 37 Physician/Pediatric Medicine
Indicates primary specialty

NPI Profile & details for EASLEY PEDIATRICS PA

NPI Number 1710931290
LBN Legal business name EASLEY PEDIATRICS PA
Authorized official GARY GOUDELOCK - (PRESIDENT)
Entity Organization
Organization subpart 1 No
Enumeration date 05/20/2006
Last updated 08/22/2020 - About 6 years ago
Identifiers
SC Medicaid PA8900
1 Some organization health care providers are made up of components that furnish different types of health care or have separate physical locations where health care is furnished. These components and physical locations are not themselves legal entities, but are part of the organization health care provider (which is a legal entity). A covered organization provider may decide that its subparts (if it has any) should have their own NPI numbers. If a subpart conducts any HIPAA standard transactions on its own (e.g., separately from its parent), it must obtain its own NPI number.

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