Healthcare Provider Details

I. General information

NPI: 1487630554
Provider Name (Legal Business Name): JORGE O GARCIA, M.D., LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 12/20/2005
Last Update Date: 03/18/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2531 EVANS ST SUITE A
NEWBERRY SC
29108-2939
US

IV. Provider business mailing address

2531 EVANS ST SUITE A
NEWBERRY SC
29108-2939
US

V. Phone/Fax

Practice location:
  • Phone: 803-276-7978
  • Fax: 803-675-0750
Mailing address:
  • Phone: 803-276-7978
  • Fax: 803-675-0750

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number
License Number State

VIII. Authorized Official

Name: DR. JORGE O GARCIA
Title or Position: PROVIDER
Credential: M.D
Phone: 803-276-7978