Individual
ANDREW JOSEPH BACON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
171 ASHLEY AVE, CHARLESTON, SC 29425-0100
(843) 792-2300
Mailing address
5155 LANCASTER ST, NORTH CHARLESTON, SC 29405-4129
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
Primary
247764
SC
Other
Enumeration date
05/18/2026
Last updated
05/18/2026
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