Individual
MR. KENT H KISTLER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1130 GROVE RD, GREENVILLE, SC 29605-4620
(864) 232-9644
(864) 232-7825
Mailing address
1130 GROVE RD, GREENVILLE, SC 29605-4620
(864) 232-9644
(864) 232-7825
Taxonomy
Speciality
Code
Description
License number
State
2084N0400X
Neurology Physician
Primary
12022
SC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
120229
—
SC
Enumeration date
08/22/2005
Last updated
06/25/2012
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