Individual
DR. JACOB PATRICK OSSOFF
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
15 EXCHANGE DR, LUGOFF, SC 29078-9198
(803) 408-3277
Mailing address
15 EXCHANGE DR, LUGOFF, SC 29078-9198
(803) 408-3277
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
MD52317
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
523179
—
SC
Enumeration date
05/06/2013
Last updated
05/26/2020
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