Kiesau Gynecology Associates

LBN: Mary Black Health System, Llc
Kiesau Gynecology Associates is an health care organization with primary practice located at 123 Dillon Dr , Spartanburg SC 29307-1017. The organization recently has 4 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Obstetrics & Gynecology, Allopathic & Osteopathic Physicians / Gynecology, Allopathic & Osteopathic Physicians / Obstetrics, Suppliers / Durable Medical Equipment & Medical Supplies. Allopathic & Osteopathic Physicians / Obstetrics & Gynecology is the primary health care specialty. Mary Black Health System, Llc can be contacted via phone (864) 585-8064, or through Hurley, Rebecca via phone (214) 473-3993.

Contact Information

Primary practice address
123 Dillon Dr Spartanburg SC 29307-1017
Phone: (864) 585-8064
Fax:
Website:
Map and Directions
Authorized official contact:
Name: Hurley, Rebecca
Phone: (214) 473-3993

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Obstetrics & Gynecology 207V00000X
Allopathic & Osteopathic Physicians / Gynecology 207VG0400X
Allopathic & Osteopathic Physicians / Obstetrics 207VX0000X
Suppliers / Durable Medical Equipment & Medical Supplies 332B00000X

Profile Details

NPI number 1710995105
LBN Legal business name Mary Black Health System, Llc
DBA Doing business as Kiesau Gynecology Associates
Authorized official Hurley, Rebecca
Entity Organization
Organization subpart 1 No
Enumeration date Aug 3rd, 2006
Last updated Aug 22nd, 2020 - about 4 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1710995105 NPPES
South Carolina MEDICAID GP3445

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