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General NPI Number Information
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NPI Number | 1295965051
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Entity Type | Organization
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Legal Business Name | PALMETTO GASTROENTEROLOGY, PA
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Dates
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Enumeration Date | 07/15/2009
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Last Update Date | 07/15/2009
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Provider Practice Location Address
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Address Line | 2750 LAUREL ST STE 201
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City | COLUMBIA
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State | SC
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Zip | 29204-2038
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Country | US
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Telephone | 803-799-2219
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Fax | 803-933-0725
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Provider Business Mailing Address
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Address Line | 2750 LAUREL ST STE 201
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City | COLUMBIA
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State | SC
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Zip | 29204-2038
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Country | US
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Telephone | 803-799-2219
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Fax | 803-933-0725
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Authorized Official
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Title or Position | PRESIDENT
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Name | GEORGE ALEXANDER JENKINS,III
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Credential | MD
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Telephone | 803-799-2219
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207RG0100X
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Taxonomy Name | Gastroenterology Physician
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License Number |
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License Number State |
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