Healthcare Provider Details

I. General information

NPI: 1720728223
Provider Name (Legal Business Name): JONATHAN TAYLOR THOMAS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/31/2022
Last Update Date: 08/05/2026
Certification Date: 08/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3093 S HIGHWAY 14 STE 101
GREER SC
29650-4874
US

IV. Provider business mailing address

3093 SC-14 SUITE 101
GREER SC
29650
US

V. Phone/Fax

Practice location:
  • Phone: 864-720-1900
  • Fax: 864-720-1901
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number96708
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: