Individual
JENNIFER R. HUCKS
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1 RICHLAND MEDICAL PARK DR, SUITE 300, COLUMBIA, SC 29203-6834
(803) 799-5022
(803) 799-5890
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
27068
SC
207RP1001X
Pulmonary Disease Physician
Primary
27068
SC
208000000X
Pediatrics Physician
27068
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
270682
—
SC
01
—
AA52662603
MEDICARE PTAN
SC
Enumeration date
09/07/2007
Last updated
09/10/2020
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