Individual
DR. DWAYNE AUBREY JACOBUS
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.P.M.
Contact information
Practice address
3800 N MAIN ST STE B, COLUMBIA, SC 29203-6446
(803) 705-3172
(803) 705-3173
Mailing address
169 LAURELHURST AVE, COLUMBIA, SC 29210-3825
(803) 733-5969
(803) 753-5591
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
565
SC
213E00000X
Podiatrist
847
TN
213EP1101X
Primary Podiatric Medicine Podiatrist
Primary
565
SC
213EP1101X
Primary Podiatric Medicine Podiatrist
847
TN
213ES0131X
Foot Surgery Podiatrist
565
SC
213ES0131X
Foot Surgery Podiatrist
847
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PD5658
—
SC
05
—
Q058390
—
TN
01
—
T14910A
MEDICARE TN
TN
Enumeration date
10/31/2005
Last updated
03/07/2023
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us