Jacocks, Charles West

Jacocks, Charles West is an individual health care provider with primary practice located at 2300 Ramsey St Rm 304-A , Fayetteville NC 28301-3856. He recently has only one registered license in Allopathic & Osteopathic Physicians / Cardiovascular Disease, which is considered as his primary health care specialty. Jacocks, Charles West can be contacted via phone (910) 488-2120.

Contact Information

Primary practice address
2300 Ramsey St Rm 304-A Fayetteville NC 28301-3856
Phone: (910) 488-2120
Fax:
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Cardiovascular Disease 207RC0000X 14114 South Carolina

Profile Details

NPI number 1720051105
LBN Legal business name Jacocks, Charles West
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Feb 8th, 2006
Last updated Jul 31st, 2019 - about 6 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 1720051105 NPPES
South Carolina MEDICAID 141144

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