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Contact Information

BYRON JACKSON, DPM
3310 MAGNOLIA ST
ORANGEBURG, SC29115-1466
 Phone: 803-531-6900
 Fax: 803-531-6907
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Podiatrist

213E00000X 48 Podiatry
Indicates primary specialty

NPI Profile & details for BYRON JACKSON · (Male)

NPI Number 1265516447
Status Active
Credentials DPM (Doctor of Podiatric Medicine)
Entity Individual
Enumeration date 10/25/2006
Last updated 07/26/2022 - About 4 years ago
Sole proprietor 1 Yes
Identifiers
  • SC License # 519
  • SC Medicaid PD5195
Hospital affiliation(s)
  • TRMC OF ORANGEBURG & CALHOUN - (Acute Care)
    3000 ST MATTHEWS RD BOX 1806
    ORANGEBURG, SC 29115
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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