Individual
JEFFRE ROGERS MCCUTCHEON
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
200 W EVANS ST, FLORENCE, SC 29501-3469
(843) 661-1531
Mailing address
1214 W ROSENEATH RD, FLORENCE, SC 29501-5748
(843) 250-5595
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
3191
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3191
LICENSE NUMBER
SC
Enumeration date
08/14/2019
Last updated
08/14/2019
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