| Doctor Name: | JESSIE C SANTIAGO |
| NPI Number: | 1003890591 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | PA C |
| License Number: | 1041578 |
| Business Practice Address: | 1 Pinckney Blvd Attn Professional Affairs Coordinator Beaufort, SC - 299026148 |
| Business Phone Number: | 8432285577 |
| Business Fax Number: | 8432285196 |
| Mailing Address: | Po Box 6216a, 1 Pinckney Blvd Attn Professional Affairs Coordinator BEAUFORT |
| State: | SC |
| Postal Code: | 299026148 |
| Phone Number: | 8432285577 |
| Fax Number: | 8432285196 |
| NPI Enumeration Date: | 11/30/2005 |
| NPI Last Update Date: | 07/08/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363AM0700X |
| License Number: | 1041578 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | GA |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Physician Assistant |
| Taxonomy Specialization: | Medical |
| Taxonomy Definition: | |