Individual
JENNIFER LYNN FOUQUETTE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
2117 GERVAIS ST, COLUMBIA, SC 29204-1805
(803) 744-0540
(803) 744-0542
Mailing address
489 FORT JOHNSON RD, CHARLESTON, SC 29412-9114
(843) 469-2973
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
Primary
31446
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
314467
—
SC
Enumeration date
12/18/2006
Last updated
07/23/2024
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