Individual
DR. JONATHAN BRAUN KSOR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
D.P.M.
Contact information
Practice address
2502 BROAD ST, CAMDEN, SC 29020-2238
(803) 425-5510
(803) 432-4776
Mailing address
2502 BROAD ST, CAMDEN, SC 29020-2238
(803) 425-5510
(803) 432-4776
Taxonomy
Speciality
Code
Description
License number
State
213E00000X
Podiatrist
PO3095
FL
213E00000X
Podiatrist
Primary
POD.614 POD
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PD6149
—
SC
Enumeration date
05/14/2007
Last updated
04/27/2017
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