Individual
DR. JACKSON B BRUCE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
115 BEATTIE PARK RD, PIEDMONT, SC 29673
(864) 845-3331
(864) 845-3152
Mailing address
115 BEATTIE PARK RD, PIEDMONT, SC 29673
(864) 845-3331
(864) 845-3152
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
19008
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
19008
—
SC
Enumeration date
10/26/2006
Last updated
09/15/2011
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