Individual
KENNETH G JACKSON JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
885 TIGER BLVD, CLEMSON, SC 29631-1480
(864) 654-2067
(864) 653-5926
Mailing address
PO BOX 100174, COLUMBIA, SC 29202-3174
(864) 512-5725
(864) 512-8039
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
LL33560
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
335603
—
SC
Enumeration date
06/30/2011
Last updated
12/01/2022
About Stedi
Stedi is the only programmable healthcare clearinghouse. You can use Stedi's APIs to process eligibility checks, claims, remits, and more.
Contact us