Individual
WILLIAM M. JACKSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
955 RIBAUT RD, BEAUFORT, SC 29902-5441
(843) 522-5130
(843) 522-5538
Mailing address
PO BOX 49009, GREENWOOD, SC 29649-0001
(864) 223-3070
(864) 223-1396
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
15477
SC
2085R0204X
Vascular & Interventional Radiology Physician
Primary
15477
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
154772
—
SC
Enumeration date
05/31/2006
Last updated
12/07/2023
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