Individual
JOHN KSOR
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DPM
Contact information
Practice address
2502 BROAD ST, CAMDEN, SC 29020-2238
(803) 425-5510
Mailing address
2502 BROAD ST, CAMDEN, SC 29020-2238
(803) 425-5510
Taxonomy
Speciality
Code
Description
License number
State
213EP1101X
Primary Podiatric Medicine Podiatrist
Primary
563
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
PD5630
—
SC
Enumeration date
02/16/2007
Last updated
04/27/2017
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