| Janet M Mckissick, MD | |
|
333 Revolutionary Trl, Fairfax, SC 29827-7109 | |
| (803) 632-2533 | |
| (803) 632-2451 |
| Full Name | Janet M Mckissick |
|---|---|
| Gender | Female |
| Speciality | Family Medicine |
| Location | 333 Revolutionary Trl, Fairfax, South Carolina |
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1407878366 | NPI | - | NPPES |
| 139790 | Medicaid | SC | |
| 13979 | Other | SC | MEDICAL LICENSE |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | 13979 (South Carolina) | Primary |
| Entity Name | Low Country Health Care System Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1053475566 PECOS PAC ID: 4284530940 Enrollment ID: O20031211000944 |
| Entity Name | Low Country Health Care System Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1780112912 PECOS PAC ID: 4284530940 Enrollment ID: O20190610001031 |
| Entity Name | Low Country Health Care System Inc |
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice |
| Entity Identifiers | NPI Number: 1306378310 PECOS PAC ID: 4284530940 Enrollment ID: O20200107003426 |
| Mailing Address | Practice Location Address |
|---|---|
| Janet M Mckissick, MD 220 Manor View Ct, Columbia, SC 29212-2330 Ph: (803) 603-0758 | Janet M Mckissick, MD 333 Revolutionary Trl, Fairfax, SC 29827-7109 Ph: (803) 632-2533 |
Robert M Jones, MD Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 333 Revolutionary Trail, Fairfax, SC 29827 Phone: 803-632-2533 Fax: 803-632-3285 | |
Christopher Michael Gamboa, MD Family Medicine Medicare: Accepting Medicare Assignments Practice Location: 1787 Allendale Fairfax Hwy, Fairfax, SC 29827 Phone: 803-632-3311 | |
Dr. Roger Eugene Nunn, MD Family Medicine Medicare: Not Enrolled in Medicare Practice Location: 1787 Allendale Fairfax Hwy, Fairfax, SC 29827 Phone: 803-632-3421 Fax: 803-632-2410 |