Individual
JACOB LUKE WAYLAND
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
LEXINGTON MEDICAL CENTER-EMERGENCY MEDICINE DEPT, 2720 SUNSET BLVD, WEST COLUMBIA, SC 29169
(803) 791-2000
Mailing address
PO BOX 6069, WEST COLUMBIA, SC 29171-6069
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
51190
SC
207P00000X
Emergency Medicine Physician
LL51190
SC
Other
Enumeration date
06/29/2017
Last updated
11/11/2020
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