Individual
JESSAMYN D BARTLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA
Contact information
Practice address
14 RICHLAND MEDICAL PARK DR STE 200, COLUMBIA, SC 29203-6882
(803) 296-9200
(803) 296-9697
Mailing address
PO BOX 22265, BELFAST, ME 04915-4473
(803) 296-7320
(803) 296-7330
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
MA052259
PA
363A00000X
Physician Assistant
Primary
1185
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
AA16692121
MEDICARE
SC
Enumeration date
02/01/2006
Last updated
03/09/2018
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