Jacobus, Dwayne Aubrey
Jacobus, Dwayne Aubrey is an sole proprietor health care provider with primary practice located at 3800 N Main St Ste B , Columbia SC 29203-6446. He recently has 3 registered licenses in different health care specialties including Podiatric Medicine & Surgery Service Providers / Podiatrist, Podiatric Medicine & Surgery Service Providers / Primary Podiatric Medicine, Podiatric Medicine & Surgery Service Providers / Foot Surgery. Podiatric Medicine & Surgery Service Providers / Primary Podiatric Medicine is his primary health care specialty. Jacobus, Dwayne Aubrey can be contacted via phone (803) 705-3172.Contact Information
Primary practice address
3800 N Main St Ste B
Columbia SC 29203-6446
Phone: (803) 705-3172
Fax: (803) 705-3173
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Podiatric Medicine & Surgery Service Providers / Podiatrist | 213E00000X | 565 | South Carolina |
| Podiatric Medicine & Surgery Service Providers / Podiatrist | 213E00000X | 847 | Tennessee |
| Podiatric Medicine & Surgery Service Providers / Primary Podiatric Medicine | 213EP1101X | 847 | Tennessee |
| Podiatric Medicine & Surgery Service Providers / Foot Surgery | 213ES0131X | 847 | Tennessee |
| Podiatric Medicine & Surgery Service Providers / Foot Surgery | 213ES0131X | 565 | South Carolina |
| Podiatric Medicine & Surgery Service Providers / Primary Podiatric Medicine | 213EP1101X | 565 | South Carolina |
Profile Details
| NPI number | 1295726172 |
|---|---|
| LBN Legal business name | Jacobus, Dwayne Aubrey |
| Credentials | Doctor of Podiatric Medicine (DPM) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Oct 31st, 2005 |
| Last updated | Mar 7th, 2023 - about last year |
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 | 1295726172 | NPPES |
| Tennessee | Other | T14910A | MEDICARE TN |
| Tennessee | MEDICAID | PD5658 | MEDICARE TN |
| Tennessee | MEDICAID | Q058390 | MEDICARE TN |
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