Individual
KINSEY KNIGHT SOUTHARD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
PA-C
Contact information
Practice address
2145 HENRY TECKLENBURG DR STE 220, CHARLESTON, SC 29414-5894
(843) 723-8823
(843) 606-8059
Mailing address
PO BOX 751649, CHARLOTTE, NC 28275-1649
(888) 472-0043
(843) 724-2440
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
1808
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1474PA
—
SC
Enumeration date
07/30/2012
Last updated
11/26/2025
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