Individual
KENNETH BLIND
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Contact information
Practice address
2720 SUNSET BLVD, WEST COLUMBIA, SC 29169-4810
(803) 791-2350
(803) 791-2520
Mailing address
300 EAST HOSPITAL ROAD, FORT GORDON, GA 30905
(706) 787-1745
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
4200
SC
363AM0700X
Medical Physician Assistant
Primary
4200
SC
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
08/31/2020
Last updated
04/20/2023
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