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General NPI Number Information
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NPI Number | 1316058837
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Entity Type | Individual
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Provider Name | BARTO PAUL KELLETT MD
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Gender | Male
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Dates
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Enumeration Date | 08/31/2006
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Last Update Date | 11/21/2023
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Provider Practice Location Address
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Address Line | RELIANT GERIATRICS 3523 PELHAM RD, SUITE C
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City | GREENVILLE
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State | SC
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Zip | 29615-4191
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Country | US
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Telephone | 864-306-0966
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Fax | 864-306-2544
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Provider Business Mailing Address
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Address Line | RELIANT GERIATRICS P.O. BOX 14611
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City | GREENVILLE
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State | SC
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Zip | 29610-4611
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Country | US
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Telephone | 864-306-0966
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Fax | 864-306-2544
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207QG0300X
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Taxonomy Name | Geriatric Medicine (Family Medicine) Physician
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License Number | 8851
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License Number State | SC
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 8851
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License Number State | SC
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