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General NPI Number Information
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NPI Number | 1164871273
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Entity Type | Individual
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Provider Name | JASON KEARNES M.D.
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Gender | Male
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Dates
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Enumeration Date | 06/09/2016
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Last Update Date | 04/21/2025
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Provider Practice Location Address
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Address Line | 117 ALPINE CIR STE 600
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City | COLUMBIA
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State | SC
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Zip | 29223-6526
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Country | US
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Telephone | 803-727-5520
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Fax | 800-910-4679
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Provider Business Mailing Address
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Address Line | 125 ALPINE CIR
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City | COLUMBIA
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State | SC
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Zip | 29223-6385
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Country | US
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Telephone | 803-779-3548
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Fax | 803-779-7055
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | 39573
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License Number State | SC
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