Provider Demographics
NPI:1891107702
Name:PITTS, KRISTEN DEYOUNG (MD)
Entity Type:Individual
Prefix:DR
First Name:KRISTEN
Middle Name:DEYOUNG
Last Name:PITTS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:MS
Other - First Name:KRISTEN
Other - Middle Name:NICOLE
Other - Last Name:DEYOUNG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:P.O. BOX 5787
Mailing Address - Street 2:
Mailing Address - City:SPARTANBURG
Mailing Address - State:SC
Mailing Address - Zip Code:29304-5787
Mailing Address - Country:US
Mailing Address - Phone:864-582-2900
Mailing Address - Fax:864-582-4991
Practice Address - Street 1:1095 IRON ORE ROAD
Practice Address - Street 2:
Practice Address - City:SPARTANBURG
Practice Address - State:SC
Practice Address - Zip Code:29303-2239
Practice Address - Country:US
Practice Address - Phone:864-582-2900
Practice Address - Fax:864-582-4991
Is Sole Proprietor?:No
Enumeration Date:2014-05-27
Last Update Date:2023-05-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC81909207YX0007X, 207Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
No207YX0007XAllopathic & Osteopathic PhysiciansOtolaryngologyPlastic Surgery within the Head & Neck