Provider Demographics
NPI:1619954708
Name:GARCIA, JORGE O (MD)
Entity Type:Individual
Prefix:DR
First Name:JORGE
Middle Name:O
Last Name:GARCIA
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2531 EVANS ST
Mailing Address - Street 2:SUITE A
Mailing Address - City:NEWBERRY
Mailing Address - State:SC
Mailing Address - Zip Code:29108-2939
Mailing Address - Country:US
Mailing Address - Phone:803-276-7978
Mailing Address - Fax:803-675-9986
Practice Address - Street 1:2531 EVANS ST
Practice Address - Street 2:SUITE A
Practice Address - City:NEWBERRY
Practice Address - State:SC
Practice Address - Zip Code:29108-2939
Practice Address - Country:US
Practice Address - Phone:803-276-7978
Practice Address - Fax:803-675-9986
Is Sole Proprietor?:No
Enumeration Date:2005-12-29
Last Update Date:2022-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC21790207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCGP3499Medicaid
SC7371Medicare ID - Type Unspecified
SCH15339Medicare UPIN