Basic Information
| Provider Information | |||||||||
| NPI: | 1477802403 | ||||||||
| EntityType: | 2 | ||||||||
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| OrganizationName: | ROPER SAINT FRANCIS PHYSICIANS NETWORK | ||||||||
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| Mailing Information | |||||||||
| Address1: | 8536 PALMETTO COMMERCE PARKWAY | ||||||||
| Address2: | SUITE 401 | ||||||||
| City: | LADSON | ||||||||
| State: | SC | ||||||||
| PostalCode: | 294566700 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8434025001 | ||||||||
| FaxNumber: | 8437242653 | ||||||||
| Practice Location | |||||||||
| Address1: | 2881 TRICOM BLVD. | ||||||||
| Address2: | SUITE A | ||||||||
| City: | NORTH CHARLESTON | ||||||||
| State: | SC | ||||||||
| PostalCode: | 294069823 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8437633916 | ||||||||
| FaxNumber: | 8437634198 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 09/06/2012 | ||||||||
| LastUpdateDate: | 10/30/2017 | ||||||||
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| AuthorizedOfficialLastName: | CONNER | ||||||||
| AuthorizedOfficialFirstName: | REX | ||||||||
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| AuthorizedOfficialTitleorPosition: | SERVICE LINE DIRECTOR | ||||||||
| AuthorizedOfficialTelephone: | 8437891631 | ||||||||
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| IsOrganizationSubpart: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207X00000X | N | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Orthopaedic Surgery | 207XS0106X | Y | 193200000X MULTI-SPECIALTY GROUP | Allopathic & Osteopathic Physicians | Orthopaedic Surgery | Hand Surgery |
No ID Information.