Provider Demographics
NPI:1750140752
Name:SCIRCLE, EMILY JO
Entity type:Individual
Prefix:MS
First Name:EMILY
Middle Name:JO
Last Name:SCIRCLE
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:224 HERITAGE TRL
Mailing Address - Street 2:
Mailing Address - City:LEXINGTON
Mailing Address - State:SC
Mailing Address - Zip Code:29072-3534
Mailing Address - Country:US
Mailing Address - Phone:803-354-1911
Mailing Address - Fax:
Practice Address - Street 1:224 HERITAGE TRL
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:SC
Practice Address - Zip Code:29072-3534
Practice Address - Country:US
Practice Address - Phone:803-354-1911
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-03-13
Last Update Date:2024-03-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program