Provider Demographics
NPI:1902820079
Name:LAROCHE, JANE L (MD)
Entity Type:Individual
Prefix:DR
First Name:JANE
Middle Name:L
Last Name:LAROCHE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 KIRKWOOD ST
Mailing Address - Street 2:
Mailing Address - City:CAMDEN
Mailing Address - State:SC
Mailing Address - Zip Code:29020-2458
Mailing Address - Country:US
Mailing Address - Phone:803-432-0017
Mailing Address - Fax:803-432-0017
Practice Address - Street 1:BARNWELL COUNTY HOSPITAL
Practice Address - Street 2:811 REYNOLDS ROAD
Practice Address - City:BARNWELL
Practice Address - State:SC
Practice Address - Zip Code:29820
Practice Address - Country:US
Practice Address - Phone:803-541-4373
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-26
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC81743207R00000X
SC8743207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCC60983Medicare UPIN