Individual
PHILLIP WAYNE JANSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
1228 HIGHWAY 72 W, GREENWOOD, SC 29649-1816
(864) 943-0549
Mailing address
PO BOX 1705, AUGUSTA, GA 30903-1705
(706) 774-7263
(706) 774-7230
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
066956
GA
207Q00000X
Family Medicine Physician
Primary
36207
SC
Other
Enumeration date
07/06/2006
Last updated
03/15/2024
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