Gaddy, Roger A

Gaddy, Roger A is an individual health care provider with primary practice located at 880 W Moultrie St Suite 200, Winnsboro SC 29180-5218. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Gaddy, Roger A can be contacted via phone (803) 635-6461.

Contact Information

Primary practice address
880 W Moultrie St Suite 200 Winnsboro SC 29180-5218
Fax: (803) 635-4200
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 8424 South Carolina

Profile Details

NPI number 1669495917
LBN Legal business name Gaddy, Roger A
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jul 26th, 2006
Last updated Feb 27th, 2015 - about 9 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1669495917 NPPES
South Carolina MEDICAID 084241

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