Provider Demographics
NPI:1912985219
Name:NOBLES, JOHN R JR (MD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:R
Last Name:NOBLES
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:PO BOX 1213
Mailing Address - Street 2:
Mailing Address - City:BENNETTSVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29512-1213
Mailing Address - Country:US
Mailing Address - Phone:843-479-8357
Mailing Address - Fax:843-479-8347
Practice Address - Street 1:1007 CHERAW ST
Practice Address - Street 2:
Practice Address - City:BENNETTSVILLE
Practice Address - State:SC
Practice Address - Zip Code:29512-2422
Practice Address - Country:US
Practice Address - Phone:843-479-8357
Practice Address - Fax:843-479-8347
Is Sole Proprietor?:No
Enumeration Date:2006-01-06
Last Update Date:2008-08-12
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
SC10891207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC108911Medicaid
SCB92032Medicare UPIN
SC108911Medicaid