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218 Dozier Blvd Ste B, Florence, SC 29501-4075 | |
(843) 286-5150 | |
(843) 919-0560 |
Full Name | |
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Type | Facility |
Speciality | Clinic/center - Podiatric |
Location | 218 Dozier Blvd Ste B, Florence, South Carolina |
Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
Identifier | Type | State | Issuer |
---|---|---|---|
1912525916 | NPI | - | NPPES |
Taxonomy | Type | License (State) | Status |
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213ES0131X | Podiatrist - Foot Surgery | (* (Not Available)) | Secondary |
261QP1100X | Clinic/center - Podiatric | (* (Not Available)) | Primary |
Provider Name | Jordanna L Baker |
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Provider Type | Practitioner - Podiatry |
Provider Identifiers | NPI Number: 1063665636 PECOS PAC ID: 7810181872 Enrollment ID: I20101103000839 |
Mailing Address | Practice Location Address |
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218 Dozier Blvd Ste B, Florence, SC 29501-4075 Ph: (843) 286-5150 | 218 Dozier Blvd Ste B, Florence, SC 29501-4075 Ph: (843) 286-5150 |