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General NPI Number Information
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NPI Number | 1790919876
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Entity Type | Individual
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Provider Name | AMY ELLEN JAMISON M.D., M.B.A.
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Gender | Female
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Dates
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Enumeration Date | 05/05/2009
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Last Update Date | 03/14/2019
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Provider Practice Location Address
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Address Line | 1690 SKYLYN DR STE 300A
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City | SPARTANBURG
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State | SC
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Zip | 29307-1022
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Country | US
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Telephone | 864-342-4000
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Fax | 864-596-7409
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Provider Business Mailing Address
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Address Line | PO BOX 743070
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City | ATLANTA
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State | GA
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Zip | 30374-3070
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Country | US
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Telephone | 864-560-4304
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Fax | 864-560-4413
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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 | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | MD445794
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License Number State | PA
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Taxonomy #2
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Taxonomy Code | 208100000X
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Taxonomy Name | Physical Medicine & Rehabilitation Physician
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License Number | 51557
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License Number State | SC
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