Haithcock, Jacqueline Davis

Haithcock, Jacqueline Davis is an individual health care provider with primary practice located at 776 Daniel Ellis Dr , Charleston SC 29412-3094. She recently has only one registered license in Other Service Providers / Legal Medicine, which is considered as her primary health care specialty. Haithcock, Jacqueline Davis can be contacted via phone (843) 795-8100.

Contact Information

Primary practice address
776 Daniel Ellis Dr Charleston SC 29412-3094
Phone: (843) 795-8100
Fax: (843) 762-3010
Website:
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Health care specialties

SpecialtyCodeLicense #State
Other Service Providers / Legal Medicine 173000000X 16814 South Carolina

Profile Details

NPI number 1255385738
LBN Legal business name Haithcock, Jacqueline Davis
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date May 20th, 2006
Last updated Jul 9th, 2007 - about 18 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1255385738 NPPES
South Carolina MEDICAID GP3214

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