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Individual

JASON T. FANCEY

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
302 UNIVERSITY PKWY, AIKEN, SC 29801-6302
(803) 641-5000
Mailing address
PO BOX 49009, GREENWOOD, SC 29649-0001
(864) 223-3070
(864) 223-1396

Taxonomy

Speciality
Code
Description
License number
State
207ZP0102X
Anatomic Pathology & Clinical Pathology Physician
Primary
22360
SC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
223608
SC
Enumeration date
05/24/2006
Last updated
12/09/2016
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