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Individual

JACQUELYN A GOING

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
MD

Contact information

Practice address
9 RICHLAND MEDICAL PARK, STE 510, COLUMBIA, SC 29203-6860
(803) 256-2483
(803) 799-4624
Mailing address
9 RICHLAND MEDICAL PARK, STE 510, COLUMBIA, SC 29203-6860
(803) 256-2483
(803) 799-4624

Taxonomy

Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
8384
SC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
083849
SC
01
20068859
SELECT HEALTH
01
DC6996
MEDICARE RAILROAD GROUP NUMBER
01
P00184835
MEDICARE RAILROAD
01
PA1382
MEDICAID GROUP NUMBER
Enumeration date
06/27/2006
Last updated
09/25/2008
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