Healthcare Provider Details

I. General information

NPI: 1518921105
Provider Name (Legal Business Name): JEANETTE C. KINSEY M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/12/2006
Last Update Date: 06/19/2026
Certification Date: 06/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

126 DOCHENO RD
BELTON SC
29627-9528
US

IV. Provider business mailing address

126 DOCHENO RD
BELTON SC
29627-9528
US

V. Phone/Fax

Practice location:
  • Phone: 864-933-6714
  • Fax:
Mailing address:
  • Phone: 864-933-6714
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208D00000X
TaxonomyGeneral Practice Physician
License Number13682
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: