Jackson, Charles Steven
Jackson, Charles Steven is an individual health care provider with primary practice located at 10630 Clemson Blvd Ste 100, Seneca SC 29678-4546. He recently has 2 registered licenses in different health care specialties including Physician Assistants & Advanced Practice Nursing Providers / Surgical, Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant. Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant is his primary health care specialty. Jackson, Charles Steven can be contacted via phone (864) 482-6000.Contact Information
Primary practice address
10630 Clemson Blvd Ste 100
Seneca SC 29678-4546
Phone: (864) 482-6000
Fax: (864) 482-7166
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Physician Assistants & Advanced Practice Nursing Providers / Surgical | 363AS0400X | 377 | South Carolina |
| Physician Assistants & Advanced Practice Nursing Providers / Physician Assistant | 363A00000X | 377 | South Carolina |
Profile Details
| NPI number | 1649230715 |
|---|---|
| LBN Legal business name | Jackson, Charles Steven |
| Credentials | Physician's Assistant Certified (PA-C) |
| Entity | Individual |
| Sole proprietor 1 | No |
| Enumeration date | Mar 24th, 2006 |
| Last updated | May 11th, 2021 - 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 | 1649230715 | NPPES |
| South Carolina | Other | 990013229 | RR MEDICARE |
| South Carolina | MEDICAID | 2217PA | RR MEDICARE |
| South Carolina | MEDICAID | 0041PA | RR MEDICARE |
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