Dr. John Evans Stavrakos
Physical Medicine & Rehabilitation Doctor Sports Medicine
103 Sum Mor Dr
West Columbia
, South Carolina 29169-4828
Dr. John Evans Stavrakos
Physical Medicine & Rehabilitation Doctor Sports Medicine
103 Sum Mor Dr
West Columbia
, South Carolina 29169-4828
(803) 244-9212
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About
Features
Specialties
- Physical Medicine & Rehabilitation Doctor
- Sports Medicine
Languages spoken
- English
Location
First Address
- Dr. John Evans Stavrakos
- Po Box 1320
- Lexington, SC
- Zip : 29071-1320
- Phone : (803) 244-9212
Second Address
- Dr. John Evans Stavrakos
- 103 Sum Mor Dr
- West Columbia, SC
- Zip : 29169-4828
- Phone : (803) 244-9212
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Scope of Practice
| Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
|---|---|---|---|---|
| Y | 208100000X | Physical Medicine & Rehabilitation Doctor | 39963 | SC |
| N | 2081S0010X | Sports Medicine | 39963 | SC |
| N | 213ES0000X | Sports Medicine | 39963 | SC |
National Provider Identifier
| NPI | 1063426724 |
|---|---|
| Provider Name | Dr. John Evans Stavrakos |
| First Address | Lexington, SC 29071-1320 |
| Second Address | West Columbia, SC 29169-4828 |
| Gender | M |
| NPI Entity type | Individual |
| Is Sole Proprietor | No |
| Is Organization Subpart | N/A |
| Enumeration Date | 28/07/2006 |
| Last Update Date | 13/07/2016 |
Additional Identifiers
| IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
|---|---|---|
| I36957 | (02) |
NPI Footnotes
What is the National Provider Identifier (NPI)
Provider Location Address
Provider Mailing Address
Entity Type Code
1= Person: individual human being who furnishes health care;
2= Non-person: entity other than an individual human being that furnishes health care (Examples: hospital, SNF, hospital subunit, pharmacy, or HMO)
What is a Subpart?
Provider Other Organization Name
1 = former name;
2 = professional name;
3 = doinq business as (d/b/ a) name;
4 = former legal business name;
5 = other.