Individual
DR. RAYMOND ELLSWORTH JIMISON II
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
11 ROBERT SMALLS PKWY, BEAUFORT, SC 29906-4216
(843) 524-8302
(843) 379-5974
Mailing address
PO BOX 4207, BEAUFORT, SC 29903-4207
(843) 846-1239
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
634
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
140732
—
SC
Enumeration date
04/24/2006
Last updated
02/21/2011
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