Individual
JESSE CLANTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2 MEDICAL PARK RD STE 300, COLUMBIA, SC 29203-6839
(803) 545-5800
(803) 929-0492
Mailing address
3110 MACCORKLE AVE SE, CHARLESTON, WV 25304-1210
(304) 347-1297
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
26438
WV
390200000X
Student in an Organized Health Care Education/Training Program
—
OH
Other
Enumeration date
06/26/2009
Last updated
09/09/2020
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