Individual
JESSICA ANNE MASOCOL
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
300 SCUFFLETOWN RD, SIMPSONVILLE, SC 29681-7204
(864) 329-0029
Mailing address
1 INDEPENDENCE PT, SUITE 212, GREENVILLE, SC 29615-4545
(864) 797-6044
(864) 797-6198
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
36907
SC
207Q00000X
Family Medicine Physician
ME114027
FL
207QG0300X
Geriatric Medicine (Family Medicine) Physician
0116025456
VA
Other
Enumeration date
09/10/2012
Last updated
12/17/2021
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