Provider Demographics
NPI:1902976426
Name:UPSTATE EMERGENCY SERVICE
Entity Type:Organization
Organization Name:UPSTATE EMERGENCY SERVICE
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:DR
Authorized Official - First Name:PAUL
Authorized Official - Middle Name:DANIEL
Authorized Official - Last Name:KARNS
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:864-490-9199
Mailing Address - Street 1:PO BOX 1628
Mailing Address - Street 2:
Mailing Address - City:GAFFNEY
Mailing Address - State:SC
Mailing Address - Zip Code:29342-1628
Mailing Address - Country:US
Mailing Address - Phone:864-490-9199
Mailing Address - Fax:
Practice Address - Street 1:1530 N LIMESTONE ST
Practice Address - Street 2:
Practice Address - City:GAFFNEY
Practice Address - State:SC
Practice Address - Zip Code:29340-4742
Practice Address - Country:US
Practice Address - Phone:864-487-1544
Practice Address - Fax:864-487-1634
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-11-09
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC6329Medicare ID - Type UnspecifiedMEDICARE GROUP NUMBER