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Individual

DR. WILLIAM SCOTT KELLOGG

Active
Sole proprietor
Yes

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
1105 N LAFAYETTE DR, SUITE A, SUMTER, SC 29150-2913
(803) 934-8833
(803) 934-0787
Mailing address
PO BOX 1244, SUMTER, SC 29151-1244
(803) 934-8833
(803) 934-0787

Taxonomy

Speciality
Code
Description
License number
State
207RH0003X
Hematology & Oncology Physician
Primary
17231
SC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
172315
SC
01
57-1111938
TAX ID
SC
01
G2590566528
MEDICARE ID-TYPE UNSPECIFIED
SC
Enumeration date
05/03/2006
Last updated
11/03/2014
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