Healthcare Provider Details

I. General information

NPI: 1316168040
Provider Name (Legal Business Name): KACEY YOUNG EICHELBERGER M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/01/2007
Last Update Date: 11/26/2025
Certification Date: 11/26/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

890 W FARIS RD STE 470
GREENVILLE SC
29605-4253
US

IV. Provider business mailing address

300 E MCBEE AVE STE 300
GREENVILLE SC
29601-2899
US

V. Phone/Fax

Practice location:
  • Phone: 864-455-1600
  • Fax: 864-455-3095
Mailing address:
  • Phone: 864-522-8603
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207VM0101X
TaxonomyMaternal & Fetal Medicine Physician
License Number35654
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: