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NPI Code Detail

MEDICARE: JEWELL FAMILY AND ELDER MEDICINE PA

MEDICARE: JEWELL FAMILY AND ELDER MEDICINE PA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1207QG0300XGeriatric Medicine (Family Medicine) Physician

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1215982533
Entity Type Code : Organization
Provider Name (Legal Business Name) : JEWELL FAMILY AND ELDER MEDICINE PA
Provider Business Mailing Address
First Line : 1218 AUBURNDALE LANE
Second Line :
City : ROCK HILL
State : SC
Zip : 29732
Country : US
Telephone Number : 803-366-4818
Fax Number : 803-366-4818
Provider Business Practice Location Address
First Line : 1147 EBENEZER RD
Second Line :
City : ROCK HILL
State : SC
Zip : 29732-2355
Country : US
Telephone Number : 803-329-6648
Fax Number : 803-985-4134
Authorized Official
Title or Position : PRESIDENT
Name : JAMES LEE JEWELL
Credential : MD
Telephone Number : 803-329-6648
Provider Enumeration Date : 05/24/2006
Last Update Date : 11/12/2014

Similar Medicare Providers

1063413136 — DR. JAMES LEE JEWELL MD
Practice Location Address:
1147 EBENEZER RD
ROCK HILL, SC
29732-2355
Practice Phone: 803-329-6648
Practice Fax: 803-985-4134
1255333779 — MS. ERIN RENEE SMITH FNP
Practice Location Address:
1147 EBENEZER RD
ROCK HILL, SC
29732-2355
Practice Phone: 803-329-6648
Practice Fax: 803-985-4134
1942568829 — ANDREA HOPE SPEECH PATHOLOGY LLC
Practice Location Address:
1147 EBENEZER RD
ROCK HILL, SC
29732-2355
Practice Phone: 803-230-1529
Practice Fax: 803-985-4134
1184075475 — CLARISSA CARELOCK-LEE
Practice Location Address:
1147 EBENEZER RD
ROCK HILL, SC
29732-2355
Practice Phone: 803-329-6648
Practice Fax:
1497204119 — ANNA TATIRA MATARUKA FNP
Practice Location Address:
1147 EBENEZER RD
ROCK HILL, SC
29732-2355
Practice Phone: 803-329-6648
Practice Fax: 803-985-4134
1003384165 — DR. LAWANDA ROLLINS DNP, AGNP-C
Practice Location Address:
8831 SATYR HILL RD STE 100
PARKVILLE, MD
21234-2355
Practice Phone: 443-946-1896
Practice Fax: 443-495-2902

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