Buckaloo, Jerrold M
Buckaloo, Jerrold M is an individual health care provider with primary practice located at 1175 Cook Rd Suite 215, Orangeburg SC 29118-8201. He recently has only one registered license in Allopathic & Osteopathic Physicians / Hand Surgery, which is considered as his primary health care specialty. Buckaloo, Jerrold M can be contacted via phone (803) 395-3837.Contact Information
Primary practice address
1175 Cook Rd Suite 215
Orangeburg SC 29118-8201
Phone: (803) 395-3837
Fax: (803) 536-5122
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Hand Surgery | 207XS0106X | 20903 | South Carolina |
Profile Details
| NPI number | 1558466516 |
|---|---|
| LBN Legal business name | Buckaloo, Jerrold M |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Sep 14th, 2006 |
| Last updated | Feb 12th, 2015 - about 9 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 | 1558466516 | NPPES |
| South Carolina | Other | P00727280 | RAILROAD MEDICARE ID-RSFPN |
| South Carolina | MEDICAID | 209036 | RAILROAD MEDICARE ID-RSFPN |
| South Carolina | Other | P00401081 | RAILROAD MEDICARE ID-RSFPN |
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