Individual
BYRON JACKSON
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
3310 MAGNOLIA ST, ORANGEBURG, SC 29115-1466
(803) 531-6900
(803) 531-6907
Mailing address
3310 MAGNOLIA ST, ORANGEBURG, SC 29115-1466
(803) 531-6900
(803) 531-6907
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
519
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PD5195
—
SC
Enumeration date
10/25/2006
Last updated
07/26/2022
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