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NPI Code Detail

MEDICARE: DR. KEVIN WRIGHT CARSON M.D.

MEDICARE: DR. KEVIN WRIGHT CARSON M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1208600000XSurgery Physician18545SC
2208600000XSurgery Physician049879GA

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
19337OTHERSCGROUP MEDICARE

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
4MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1609880715
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. KEVIN WRIGHT CARSON M.D.
Provider Business Mailing Address
First Line : 160 ACADEMY AVE
Second Line :
City : GREENWOOD
State : SC
Zip : 29646-3808
Country : US
Telephone Number : 864-223-8090
Fax Number : 864-223-4026
Provider Business Practice Location Address
First Line : 160 ACADEMY AVE
Second Line :
City : GREENWOOD
State : SC
Zip : 29646-3808
Country : US
Telephone Number : 864-223-8090
Fax Number : 864-223-4026
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/27/2006
Last Update Date : 03/17/2014

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