Healthcare Provider Details

I. General information

NPI: 1053568287
Provider Name (Legal Business Name): JEFFREY INNES FROHOCK M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/19/2008
Last Update Date: 06/03/2010
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

125 DOUGHTY ST STE 420
CHARLESTON SC
29403-5741
US

IV. Provider business mailing address

125 DOUGHTY ST STE 420
CHARLESTON SC
29403-5741
US

V. Phone/Fax

Practice location:
  • Phone: 843-723-3441
  • Fax: 843-805-4040
Mailing address:
  • Phone: 843-723-3441
  • Fax: 843-805-4040

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberTRN9254
License Number StateFL
# 2
Primary TaxonomyY
Taxonomy Code207L00000X
TaxonomyAnesthesiology Physician
License NumberMMD.32582 TL
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: