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Individual

DR. JAMES WILKS FANT JR.

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
2 MEDICAL PARK RD, SUITE 501, COLUMBIA, SC 29203-6808
(803) 434-3320
(803) 540-1111
Mailing address
PO BOX 743904, ATLANTA, GA 30374-3904
(803) 296-7320
(803) 296-7330

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
17608
SC
207RR0500X
Rheumatology Physician
Primary
17608
SC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
176080
SC
Enumeration date
03/07/2006
Last updated
04/22/2021
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