Ewart, Jackson M
Ewart, Jackson M is an sole proprietor health care provider with primary practice located at 903 N Fraser St # A , Georgetown SC 29440-2879. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Surgery, Allopathic & Osteopathic Physicians / Vascular Surgery. Allopathic & Osteopathic Physicians / Vascular Surgery is his primary health care specialty. Ewart, Jackson M can be contacted via phone (843) 527-1331.Contact Information
Primary practice address
903 N Fraser St # A
Georgetown SC 29440-2879
Phone: (843) 527-1331
Fax: (843) 527-1332
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Allopathic & Osteopathic Physicians / Surgery | 208600000X | 8834 | South Carolina |
Allopathic & Osteopathic Physicians / Vascular Surgery | 2086S0129X | 8834 | South Carolina |
Profile Details
NPI number | 1699955005 |
---|---|
LBN Legal business name | Ewart, Jackson M |
Credentials | Doctor of Medicine (MD) |
Entity | Individual |
Sole proprietor 1 | Yes |
Enumeration date | Nov 14th, 2007 |
Last updated | Aug 5th, 2020 - about 5 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 | 1699955005 | NPPES |
South Carolina | Other | 7399 | MEDICARE GROUP PTAN |
South Carolina | MEDICAID | 088345 | MEDICARE GROUP PTAN |
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