Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207VG0400X | Gynecologist | 14146 | SC |
Y | 207VX0201X | Gynecologic Oncologist | 14146 | SC |
NPI | 1316942857 |
---|---|
Provider Name | Dr. Thomas Scott Jennings |
First Address | Charleston, SC 29407-4835 |
Second Address | Charleston, SC 29407-4835 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 20/06/2005 |
Last Update Date | 06/01/2022 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
141466 | (05) | SC |