MEDICARE: DR. JORDAN CELEST HAYGOOD PHARMD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1835P1300X	Psychiatric Pharmacist	36810	SC

General Provider Information

NPI Number	:	1689159642
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JORDAN CELEST HAYGOOD PHARMD

Provider Business Mailing Address
First Line	:	422 ROPER POND CIR
Second Line	:
City	:	COLUMBIA
State	:	SC
Zip	:	29206-1754
Country	:	US
Telephone Number	:	706-631-1981
Fax Number	:

Provider Business Practice Location Address
First Line	:	67 PRESIDENT ST
Second Line	:
City	:	CHARLESTON
State	:	SC
Zip	:	29425-5712
Country	:	US
Telephone Number	:	843-792-5952
Fax Number	:	843-792-5954

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	09/26/2018
Last Update Date	:	12/01/2025

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