Charles W Jackson PH.D.

NPI 1851315766 - Psychologist - 103TC1900X

NPI Details
NPI 1851315766
Gender Male
Enumeration Date 07/26/2006
Last Updated 07/08/2007
Entity Type Individual
Active Over 10 years ago
Practice Location
210 UNIVERSITY PLAZA DR
CONWAY SC, 29526-8978, US
Phone (843) 347-2550
Fax
Business Location
5315 N KINGS HWY
PMB 120
MYRTLE BEACH SC, 29577-2534, US
Phone (843) 503-2000
Fax (843) 272-3032
Toxanomy
Taxonomy Code 103TC1900X
License State South Carolina
License Number 182
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According to our database, Dr. Charles W Jackson PH.D. NPI is 1851315766, taxonomy code is 103TC1900X and license number is 182, license state is located at South Carolina. Charles W Jackson PH.D. physically located at 210 University Plaza Dr, Conway SC, 29526-8978. NPI Number Charles W Jackson PH.D. has the Individual type.

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1851315766 NPI number is provided on an as is basis without warranty of any kind. 1851315766 is maintained by the National Plan & Provider Enumeration System. The contents of Charles W Jackson PH.D. are for informational purposes only.