Healthcare Provider Details

I. General information

NPI: 1922531466
Provider Name (Legal Business Name): KARL KINGRY D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/11/2017
Last Update Date: 08/29/2025
Certification Date: 08/29/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

BLDG #598 GEIGER BLVD
BEAUFORT SC
29905
US

IV. Provider business mailing address

BLDG #598 GEIGER BLVD
BEAUFORT SC
29905
US

V. Phone/Fax

Practice location:
  • Phone: 843-228-7424
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2083A0100X
TaxonomyAerospace Medicine Physician
License NumberDO52101
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: