Search › South Carolina › 1710I1002X
Keelan Jackson
NPI 1790449882 · on the registry since 2021
Practice
- Address
- 670 Boulevard De France
Parris Island, SC 29905 - Phone
- (843) 228-4757
- Clinicians at this address
- 15
Registry record
- Primary taxonomy
- 1710I1002X
1710I1002X
- Also registered as
- 390200000X
- Licence states on file
- SC
From the registry's licence fields, which are often incomplete.
- Sex
- Male
- Record last updated
- 2026-08-04
Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in South Carolina