Individual
DR. KINCHEN BALLENTINE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
420 THOMSON CIR, ABBEVILLE, SC 29620
(864) 366-5011
(864) 366-3343
Mailing address
P O BOX 887, ABBEVILLE, SC 29620
(864) 366-5011
(864) 366-3343
Taxonomy
Speciality
Code
Description
License number
State
2085B0100X
Body Imaging Physician
Primary
HTL-098
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
N17751
—
SC
Enumeration date
12/06/2006
Last updated
10/25/2007
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