Provider Demographics
NPI:1477653723
Name:CAROLINA KIDS PEDIATRICS, P.A.
Entity Type:Organization
Organization Name:CAROLINA KIDS PEDIATRICS, P.A.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT/MEDICAL DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:E
Authorized Official - Last Name:FEISTE
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:864-888-3020
Mailing Address - Street 1:10706 CLEMSON BLVD
Mailing Address - Street 2:
Mailing Address - City:SENECA
Mailing Address - State:SC
Mailing Address - Zip Code:29678-4528
Mailing Address - Country:US
Mailing Address - Phone:864-888-3020
Mailing Address - Fax:864-888-8585
Practice Address - Street 1:10706 CLEMSON BLVD
Practice Address - Street 2:
Practice Address - City:SENECA
Practice Address - State:SC
Practice Address - Zip Code:29678-4528
Practice Address - Country:US
Practice Address - Phone:864-888-3020
Practice Address - Fax:864-888-8585
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-25
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC23556208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208000000XAllopathic & Osteopathic PhysiciansPediatricsGroup - Single Specialty