Jimison, Raymond Ellsworth

Jimison, Raymond Ellsworth is an sole proprietor health care provider with primary practice located at 11 Robert Smalls Pkwy , Beaufort SC 29906-4216. He recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as his primary health care specialty. Jimison, Raymond Ellsworth can be contacted via phone (843) 524-8302.

Contact Information

Primary practice address
11 Robert Smalls Pkwy Beaufort SC 29906-4216
Fax: (843) 379-5974
Website:

Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X 634 South Carolina

Profile Details

NPI number 1346206919
LBN Legal business name Jimison, Raymond Ellsworth
Credentials Doctor of Optometry (OD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Apr 24th, 2006
Last updated Feb 21st, 2011 - about 14 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 1346206919 NPPES
South Carolina MEDICAID 140732

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