Individual
DR. JONATHAN PARKS GARDNER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
9404 HIGHWAY 78 STE 100, LADSON, SC 29456-3909
(843) 737-0437
(843) 789-3053
Mailing address
9404 HIGHWAY 78 STE 100, LADSON, SC 29456-3909
(502) 855-7200
Taxonomy
Speciality
Code
Description
License number
State
207L00000X
Anesthesiology Physician
28124
SC
208VP0000X
Pain Medicine Physician
28124
SC
208VP0014X
Interventional Pain Medicine Physician
Primary
28124
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
281242
—
SC
Enumeration date
07/13/2007
Last updated
02/12/2026
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