Individual
JERRY S. PURCELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1208 ELLA ST, ANDERSON, SC 29621-4839
(864) 965-9150
(864) 965-9654
Mailing address
1208 ELLA ST, ANDERSON, SC 29621-4839
(864) 965-9150
(864) 659-6549
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
21864
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
218641
—
SC
05
—
5901065
—
NC
05
—
967617053A
—
GA
Enumeration date
04/08/2006
Last updated
08/07/2020
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