Dickens, Jennifer C
Dickens, Jennifer C is an sole proprietor health care provider with primary practice located at 113 Millwood Dr , Fort Mill SC 29715-8356. She recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as her primary health care specialty. Dickens, Jennifer C can be contacted via phone (803) 802-9488.Contact Information
Primary practice address
113 Millwood Dr
Fort Mill SC 29715-8356
Phone: (803) 802-9488
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | MD 26669 | South Carolina |
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 2001-01321 | North Carolina |
Profile Details
| NPI number | 1760462311 |
|---|---|
| LBN Legal business name | Dickens, Jennifer C |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jan 19th, 2006 |
| Last updated | Jul 3rd, 2008 - about 17 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 | 1760462311 | NPPES |
| North Carolina | MEDICAID | 891360E |
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