Banks, Jerry Burton
Banks, Jerry Burton is an individual health care provider with primary practice located at 920 Doug White Dr Ste 250 , Myrtle Beach SC 29572-4181. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Banks, Jerry Burton can be contacted via phone (843) 848-1440.Contact Information
Primary practice address
920 Doug White Dr Ste 250
Myrtle Beach SC 29572-4181
Phone: (843) 848-1440
Fax: (843) 839-2382
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 0101232005 | Virginia |
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | MD34440 | Tennessee |
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 37612 | South Carolina |
Profile Details
| NPI number | 1578552410 |
|---|---|
| LBN Legal business name | Banks, Jerry Burton |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Oct 13th, 2005 |
| Last updated | Feb 10th, 2022 - about 2 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1578552410 | NPPES |
| Tennessee | MEDICAID | 1505595 | |
| Tennessee | MEDICAID | 037612200 | |
| Tennessee | MEDICAID | 1578552410 |
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