Provider Demographics
NPI:1306801840
Name:FLORENCE NEUROSURGERY AND SPINE PC
Entity type:Organization
Organization Name:FLORENCE NEUROSURGERY AND SPINE PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:WILLIAM
Authorized Official - Middle Name:B
Authorized Official - Last Name:NASO
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:843-673-0122
Mailing Address - Street 1:1204 E CHEVES ST
Mailing Address - Street 2:
Mailing Address - City:FLORENCE
Mailing Address - State:SC
Mailing Address - Zip Code:29506-2710
Mailing Address - Country:US
Mailing Address - Phone:843-673-0122
Mailing Address - Fax:843-673-0227
Practice Address - Street 1:1204 E CHEVES ST
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:SC
Practice Address - Zip Code:29506-2710
Practice Address - Country:US
Practice Address - Phone:843-673-0122
Practice Address - Fax:843-673-0227
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-04-18
Last Update Date:2015-06-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC208VP0014X, 207LP2900X, 2084P2900X, 207T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207T00000XAllopathic & Osteopathic PhysiciansNeurological SurgeryGroup - Multi-Specialty
No208VP0014XAllopathic & Osteopathic PhysiciansPain MedicineInterventional Pain MedicineGroup - Multi-Specialty
No207LP2900XAllopathic & Osteopathic PhysiciansAnesthesiologyPain MedicineGroup - Multi-Specialty
No2084P2900XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyPain MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCGP1454Medicaid
SC1275300001Medicare NSC
SC5147Medicare PIN