Healthcare Provider Details

I. General information

NPI: 1770072753
Provider Name (Legal Business Name): KEVIN LOWRY ESTES DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/06/2018
Last Update Date: 10/05/2026
Certification Date: 10/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2260 VISTA RD
FORT MILL SC
29708-7800
US

IV. Provider business mailing address

885 GOLD HILL RD
FORT MILL SC
29708-7946
US

V. Phone/Fax

Practice location:
  • Phone: 802-735-0001
  • Fax: 903-342-8251
Mailing address:
  • Phone: 802-735-0001
  • Fax: 903-342-8251

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number2022-01322
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code208100000X
TaxonomyPhysical Medicine & Rehabilitation Physician
License Number93817
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: