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:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:577 COVINGTON MILL POUD RD
Mailing Address - Street 2:
Mailing Address - City:BENNETTSVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29512-7177
Mailing Address - Country:US
Mailing Address - Phone:843-454-7177
Mailing Address - Fax:843-479-8347
Practice Address - Street 1:577 COVINGTON MILL POUD RD
Practice Address - Street 2:
Practice Address - City:BENNETTSVILLE
Practice Address - State:SC
Practice Address - Zip Code:29512-7177
Practice Address - Country:US
Practice Address - Phone:843-454-7177
Practice Address - Fax:843-479-8347
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-06
Last Update Date:2025-08-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC10891207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC108911Medicaid
SCB92032Medicare UPIN
SC108911Medicaid