Individual
LEVI JORDAN FOWLKES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
1120 ROBERTS BRANCH PKWY STE 200, COLUMBIA, SC 29203-9144
(803) 296-7846
Mailing address
1120 ROBERTS BRANCH PKWY STE 200, COLUMBIA, SC 29203-9144
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
—
SC
Other
Enumeration date
04/20/2026
Last updated
04/20/2026
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