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Individual

DR. KEVIN WRIGHT CARSON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
160 ACADEMY AVE, GREENWOOD, SC 29646-3808
(864) 223-8090
(864) 223-4026
Mailing address
160 ACADEMY AVE, GREENWOOD, SC 29646-3808
(864) 223-8090
(864) 223-4026

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
049879
GA
208600000X
Surgery Physician
Primary
18545
SC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1460567
LA
05
185454
SC
01
9337
GROUP MEDICARE
SC
01
GP5280
GROUP MEDICAID
SC
Enumeration date
07/27/2006
Last updated
03/17/2014
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