Jacocks, Mitchell Wells
Jacocks, Mitchell Wells is an individual health care provider with primary practice located at 2728 Sunset Blvd Ste 300 , West Columbia SC 29169-4815. He recently has only one registered license in Allopathic & Osteopathic Physicians / Cardiovascular Disease, which is considered as his primary health care specialty. Jacocks, Mitchell Wells can be contacted via phone (803) 744-4940.Contact Information
Primary practice address
2728 Sunset Blvd Ste 300
West Columbia SC 29169-4815
Phone: (803) 744-4940
Fax: (803) 744-4938
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Cardiovascular Disease | 207RC0000X | 20836 | South Carolina |
Profile Details
| NPI number | 1881667897 |
|---|---|
| LBN Legal business name | Jacocks, Mitchell Wells |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Feb 9th, 2006 |
| Last updated | Nov 6th, 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 | 1881667897 | NPPES |
| South Carolina | Other | CC5386 | RRMEDICARE |
| South Carolina | MEDICAID | T49604 | RRMEDICARE |
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