Individual
DR. ALAN MARK JOLLES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D., P.A.
Contact information
Practice address
1748 SAINT MATTHEWS RD, ORANGEBURG, SC 29118-2441
(803) 536-0613
Mailing address
PO BOX 749306, ATLANTA, GA 30374-9306
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
17228
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GP3036
—
SC
Enumeration date
07/02/2006
Last updated
11/11/2024
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