Provider Demographics
NPI:1972964302
Name:BECKSVOORT, KIRSTEN APRIL (DO)
Entity Type:Individual
Prefix:DR
First Name:KIRSTEN
Middle Name:APRIL
Last Name:BECKSVOORT
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
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Mailing Address - Street 1:325 BROAD ST
Mailing Address - Street 2:STE 100
Mailing Address - City:SUMTER
Mailing Address - State:SC
Mailing Address - Zip Code:29150-4167
Mailing Address - Country:US
Mailing Address - Phone:803-773-5227
Mailing Address - Fax:803-418-0202
Practice Address - Street 1:308 W WESMARK BLVD
Practice Address - Street 2:
Practice Address - City:SUMTER
Practice Address - State:SC
Practice Address - Zip Code:29150
Practice Address - Country:US
Practice Address - Phone:803-773-5227
Practice Address - Fax:803-905-1322
Is Sole Proprietor?:No
Enumeration Date:2016-03-12
Last Update Date:2019-12-04
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
SC82961207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCSCF8307477Medicaid