Provider Demographics
NPI:1386867760
Name:DRS KENDALL AND KEMMERLIN PA
Entity Type:Organization
Organization Name:DRS KENDALL AND KEMMERLIN PA
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:THOMAS
Authorized Official - Middle Name:WILLIAM
Authorized Official - Last Name:KENDALL
Authorized Official - Suffix:SR
Authorized Official - Credentials:MD
Authorized Official - Phone:864-234-7000
Mailing Address - Street 1:1817 WOODRUFF RD
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29607-5936
Mailing Address - Country:US
Mailing Address - Phone:864-234-7000
Mailing Address - Fax:864-234-4719
Practice Address - Street 1:1817 WOODRUFF RD
Practice Address - Street 2:
Practice Address - City:GREENVILLE
Practice Address - State:SC
Practice Address - Zip Code:29607-5936
Practice Address - Country:US
Practice Address - Phone:864-234-7000
Practice Address - Fax:864-234-4719
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-04-11
Last Update Date:2008-07-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208D00000XAllopathic & Osteopathic PhysiciansGeneral PracticeGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC2257Medicare PIN