Healthcare Provider Details

I. General information

NPI: 1356598361
Provider Name (Legal Business Name): JERI M HELTON MED
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: JERI M ROBERTS

II. Dates (important events)

Enumeration Date: 08/20/2008
Last Update Date: 08/20/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1175 N GUIGNARD DR
SUMTER SC
29150-1519
US

IV. Provider business mailing address

215 N MAGNOLIA ST
SUMTER SC
29150-4943
US

V. Phone/Fax

Practice location:
  • Phone: 803-775-7898
  • Fax: 803-773-5246
Mailing address:
  • Phone: 803-775-7898
  • Fax: 803-773-5246

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: