Provider Demographics
NPI:1942274907
Name:ALBRECHT, KATHLEEN GODBEY (MD)
Entity Type:Individual
Prefix:DR
First Name:KATHLEEN
Middle Name:GODBEY
Last Name:ALBRECHT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:300 E MCBEE AVE FL 4
Mailing Address - Street 2:
Mailing Address - City:GREENVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29601-2842
Mailing Address - Country:US
Mailing Address - Phone:864-695-6697
Mailing Address - Fax:
Practice Address - Street 1:100 PALMETTO HEALTH PKWY STE 350
Practice Address - Street 2:
Practice Address - City:COLUMBIA
Practice Address - State:SC
Practice Address - Zip Code:29212-1756
Practice Address - Country:US
Practice Address - Phone:803-907-2020
Practice Address - Fax:803-907-7720
Is Sole Proprietor?:Yes
Enumeration Date:2006-02-15
Last Update Date:2024-04-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL036092412207W00000X, 207WX0200X
SC91564207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
No207WX0200XAllopathic & Osteopathic PhysiciansOphthalmologyOphthalmic Plastic and Reconstructive Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILK09800Medicare PIN