IndividualActive
Jeffrey Herndon
NPI 1649604000 · Exclusive Provider Organization · Walterboro, SC
Provider details
- NPI number
- 1649604000
- Entity type
- Individual
- Primary specialty
- Exclusive Provider OrganizationManaged Care Organizations
- Sex
- Male
- Sole proprietor
- Yes
- License
- 165834 (SC)
Specialties & taxonomies
Managed Care Organizations
Practice location
990 Academy Rd
Walterboro, SC 29488-9266
Phone: (843) 893-8122
Fax: (843) 549-2650
Approximate (ZIP-level) locationGet directions
Mailing address
990 Academy Rd
Walterboro, SC 29488-9266
Registry dates
- Enumerated
- 2013-08-21
- Last updated
- 2013-08-21
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.