Individual
THOMAS W JARECKY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
200 PATEWOOD DR, SUITE C100, GREENVILLE, SC 29615-3593
(864) 454-4643
(864) 454-4646
Mailing address
1 INDEPENDENCE PT, SUITE 212, GREENVILLE, SC 29615-4545
(864) 797-6044
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
Primary
14792
SC
207LP2900X
Pain Medicine (Anesthesiology) Physician
14792
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
147923
—
SC
01
—
P00829559
RAILROAD MEDICARE
SC
01
—
SCA0535019
MEDICARE PIN
SC
Enumeration date
01/19/2006
Last updated
09/16/2021
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