Individual
KEVIN CARLSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
200 PATEWOOD DR STE B400, GREENVILLE, SC 29615-6306
(864) 454-4368
(864) 241-9232
Mailing address
300 E MCBEE AVE FL 4, GREENVILLE, SC 29601-2842
(864) 695-6697
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
82003
WI
207Y00000X
Otolaryngology Physician
Primary
92143
SC
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
03/29/2018
Last updated
04/08/2026
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