Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Jackson Derek Hartley, MD

Individual provider Internal Medicine Physician · NPI 1104677202

Jackson Derek Hartley, MD is an Internal Medicine Physician in Greenville, South Carolina. Practices as a sole proprietor. Licensed in South Carolina.

Licensed in
SC
In the registry since
2024
What do these letters mean?
MD — Doctor of Medicine
A physician who completed allopathic medical school.

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Practice location Address checks out

876 W Faris Rd
Greenville, SC 29605-4253
Phone: (864) 455-5648
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Internal Medicine Physician (primary) Taxonomy 207R00000X · Licence LL92431 (SC)

Record details

NPI number1104677202
Entity typeIndividual (Type 1)
GenderMale
Credentials MD
Sole proprietorYes
NPI enumeratedMarch 28, 2024
Last updated in NPPESAugust 9, 2024
Certification dateAugust 9, 2024

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