Individual
MRS. KAREN LEANNE WICKLIFFE-KEISLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
1520 BOILING SPRINGS RD, BOILING SPRINGS, SC 29316
(864) 583-6381
(864) 583-6390
Mailing address
479 HEYWOOD AVE, SPARTANBURG, SC 29307-1726
(864) 583-6381
(864) 583-6390
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
MD29782
SC
208600000X
Surgery Physician
LL29782
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
7292
MEDICARE GROUP NUMBER
SC
Enumeration date
06/12/2007
Last updated
07/09/2019
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