Individual
OMRI KENNETH WEBB
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
801 W MAIN ST, UNION, SC 29379-2717
(864) 429-3029
(864) 429-3015
Mailing address
720 S DUNCAN BYP, UNION, SC 29379-7830
(864) 427-4081
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
12908
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
129088
—
SC
01
—
P00402307
MEDICARE RAILROAD PTAN
GA
01
—
P01577395
RAILROAD MEDICARE
SC
Enumeration date
09/20/2006
Last updated
02/12/2016
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