Individual
JIMMY GREGORY STEVENS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
920 DOUG WHITE DR STE 130, MYRTLE BEACH, SC 29572-4180
(843) 848-1440
(843) 839-1654
Mailing address
920 DOUG WHITE DR STE 130, MYRTLE BEACH, SC 29572-4180
(843) 848-1440
(843) 839-1654
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
3455
SC
363A00000X
Physician Assistant
—
—
Other
Enumeration date
01/09/2020
Last updated
01/15/2025
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