Easley Pediatrics PA
NPI #1710931290 in Easley, South Carolina
Provider Information
- NPI Number
- 1710931290
- Entity Type
- Organization
- Organization Name
- Easley Pediatrics PA
- Primary Specialty
- Pediatrics
- Enumeration Date
- May 20, 2006
- Last Updated
- Aug 22, 2020
Practice Location
- Address
- 800 NORTH A ST
- City
- Easley
- State
- South Carolina
- ZIP Code
- 29640
- Phone
- (864) 855-0001
Authorized Official
- Name
- MR. GARY MORGAN GOUDELOCK, MD
- Title
- PRESIDENT
- Phone
- (864) 855-0001
Specialties & Taxonomy Codes
| Specialty |
|---|
| Pediatrics |
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