Organization
ROPER HOSPITAL INC.
Active
Other names
Roper Neuropsychology
Organization subpart
No
Provider details
NPI number
Authorized official
MR. WILLIAM ANTHONY JACKSON (CEO)
(843) 724-2954
Entity
Organization
Contact information
Practice address
316 CALHOUN ST, CHARLESTON, SC 29401-1113
(843) 724-3324
(843) 724-1995
Mailing address
PO BOX 632500, CINCINNATI, OH 45263-2500
(888) 472-0043
(513) 653-4122
Taxonomy
Speciality
Code
Description
License number
State
103G00000X
Clinical Neuropsychologist
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
GP6493
—
SC
Enumeration date
03/18/2009
Last updated
04/12/2026
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