Jeanjaquet, Mark S

Jeanjaquet, Mark S is an sole proprietor health care provider with primary practice located at 300 Singleton Ridge Rd , Conway SC 29526-9142. He recently has only one registered license in Allopathic & Osteopathic Physicians / Emergency Medicine, which is considered as his primary health care specialty. Jeanjaquet, Mark S can be contacted via phone (843) 347-8015.

Contact Information

Primary practice address
300 Singleton Ridge Rd Conway SC 29526-9142
Fax: (843) 347-8017
Website:

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X 18065 South Carolina

Profile Details

NPI number 1336171487
LBN Legal business name Jeanjaquet, Mark S
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jul 7th, 2006
Last updated Apr 30th, 2008 - about 16 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 1336171487 NPPES
Other 930045476 MEDICARE RAILROAD
MEDICAID 180654 MEDICARE RAILROAD
Other 20017271 MEDICARE RAILROAD

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