Individual
MR. JESSE WILLIAM PRICE III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C
Contact information
Practice address
180 WINGO WAY, SUITE 306, MT PLEASANT, SC 29464-1812
(843) 884-1777
(843) 884-0710
Mailing address
PO BOX 751649, CHARLOTTE, NC 28275-1649
(843) 789-1620
(843) 724-2440
Taxonomy
Speciality
Code
Description
License number
State
363AM0700X
Medical Physician Assistant
Primary
1738
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1579PA
—
SC
Enumeration date
10/26/2011
Last updated
01/05/2022
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