Jackson, Charles Steven

Jackson, Charles Steven is an individual health care provider with primary practice located at 10630 Clemson Blvd Ste 100, Seneca SC 29678-4546. He recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Surgical, Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant. Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant is his primary health care specialty. Jackson, Charles Steven can be contacted via phone (864) 482-6000.

Contact Information

Primary practice address
10630 Clemson Blvd Ste 100 Seneca SC 29678-4546
Phone: (864) 482-6000
Fax: (864) 482-7166
Website:
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Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Surgical 363AS0400X 377 South Carolina
Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant 363A00000X 377 South Carolina

Profile Details

NPI number 1649230715
LBN Legal business name Jackson, Charles Steven
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 24th, 2006
Last updated May 11th, 2021 - about 4 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 1649230715 NPPES
South Carolina Other 990013229 RR MEDICARE
South Carolina MEDICAID 2217PA RR MEDICARE
South Carolina MEDICAID 0041PA RR MEDICARE

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