Cleland, Jack Wilson

Cleland, Jack Wilson is an individual health care provider with primary practice located at 1330 Boiling Springs Rd Suite 1300, Spartanburg SC 29303-4201. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as his primary health care specialty. Cleland, Jack Wilson can be contacted via phone (864) 560-6345.

Contact Information

Primary practice address
1330 Boiling Springs Rd Suite 1300 Spartanburg SC 29303-4201
Phone: (864) 560-6345
Fax: (864) 560-6054
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X LL30778 South Carolina
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 30778 South Carolina

Profile Details

NPI number 1912166315
LBN Legal business name Cleland, Jack Wilson
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 2nd, 2008
Last updated Dec 11th, 2020 - 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.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1912166315 NPPES
South Carolina MEDICAID 307787

Popular Providers