Individual
DR. W. CLARK JERNIGAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
3150 HIGHWAY 153, PIEDMONT, SC 29673-9498
(864) 295-1231
Mailing address
3150 HIGHWAY 153, PIEDMONT, SC 29673-9498
(864) 295-1231
(864) 295-0095
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
10939
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
109395
—
SC
01
—
8157
MEDICARE PTAN
SC
Enumeration date
04/27/2006
Last updated
06/03/2022
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