Healthcare Provider Details

I. General information

NPI: 1831891472
Provider Name (Legal Business Name): JORDAN READ DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/20/2023
Last Update Date: 07/09/2026
Certification Date: 07/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1268 NEXTON PKWY
SUMMERVILLE SC
29486-3168
US

IV. Provider business mailing address

PO BOX 632516
CINCINNATI OH
45263-2516
US

V. Phone/Fax

Practice location:
  • Phone: 843-212-8080
  • Fax: 843-402-2681
Mailing address:
  • Phone: 888-472-0043
  • Fax: 513-653-4122

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number90010
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: