Basic Information
| Provider Information | |||||||||
| NPI: | 1578507877 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | COWART | ||||||||
| FirstName: | JAMES | ||||||||
| MiddleName: | DAVID | ||||||||
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| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | 1 INDEPENDENCE PT | ||||||||
| Address2: | SUITE 212 | ||||||||
| City: | GREENVILLE | ||||||||
| State: | SC | ||||||||
| PostalCode: | 296154545 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8647976044 | ||||||||
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| Practice Location | |||||||||
| Address1: | 325 MEDICAL PARKWAY | ||||||||
| Address2: | SUITE 100 | ||||||||
| City: | GREER | ||||||||
| State: | SC | ||||||||
| PostalCode: | 296502442 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8647979200 | ||||||||
| FaxNumber: | 8647979217 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/16/2006 | ||||||||
| LastUpdateDate: | 09/06/2013 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207V00000X | 22676 | SC | Y | Allopathic & Osteopathic Physicians | Obstetrics & Gynecology |
ID Information
| ID | Type | State | Issuer | Description | 7369266 | 01 | SC | AETNA | OTHER | 226767 | 05 | SC | MEDICAID | 571004971032 | 01 | SC | BCBS | OTHER |