Healthcare Provider Details

I. General information

NPI: 1013768027
Provider Name (Legal Business Name): JACOB ESKEW
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/28/2024
Last Update Date: 08/26/2024
Certification Date: 08/26/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

13 EDGEWOOD DR
GREENVILLE SC
29605-4235
US

IV. Provider business mailing address

13 EDGEWOOD DR
GREENVILLE SC
29605-4235
US

V. Phone/Fax

Practice location:
  • Phone: 864-455-7861
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License NumberLL92579
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: