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General NPI Number Information
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NPI Number | 1164620779
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Entity Type | Organization
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Legal Business Name | LOMAX AND JORDAN ENT
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Dates
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Enumeration Date | 07/05/2007
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Last Update Date | 04/20/2008
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Provider Practice Location Address
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Address Line | 208 E 2ND NORTH ST
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City | SUMMERVILLE
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State | SC
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Zip | 29483-6858
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Country | US
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Telephone | 843-873-6873
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Fax | 843-871-7111
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Provider Business Mailing Address
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Address Line | 208 E 2ND NORTH ST
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City | SUMMERVILLE
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State | SC
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Zip | 29483-6858
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Country | US
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Telephone | 843-873-6873
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Fax | 843-871-7111
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Authorized Official
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Title or Position | OWNER
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Name | DR. WILLIAM R LOMAX
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Credential | MD
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Telephone | 843-873-6873
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number |
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License Number State |
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