Healthcare Provider Details

I. General information

NPI: 1467420521
Provider Name (Legal Business Name): LAUREN JONES PAINTER MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/14/2006
Last Update Date: 02/26/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9 RICHLAND MEDICAL PARK SUITE 620
COLUMBIA SC
29203-6859
US

IV. Provider business mailing address

PO BOX 743904
ATLANTA GA
30374-3904
US

V. Phone/Fax

Practice location:
  • Phone: 803-779-6776
  • Fax: 803-779-7346
Mailing address:
  • Phone: 803-296-7320
  • Fax: 803-296-7330

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number21253
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: