Provider Demographics
NPI:1356871933
Name:ATKINSON, KRISTY KAYE (DO)
Entity type:Individual
Prefix:
First Name:KRISTY
Middle Name:KAYE
Last Name:ATKINSON
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:KRISTY
Other - Middle Name:
Other - Last Name:COLLINS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:853 N CHURCH ST # 150
Mailing Address - Street 2:
Mailing Address - City:SPARTANBURG
Mailing Address - State:SC
Mailing Address - Zip Code:29303-3098
Mailing Address - Country:US
Mailing Address - Phone:864-560-6193
Mailing Address - Fax:
Practice Address - Street 1:853 N CHURCH ST # 150
Practice Address - Street 2:
Practice Address - City:SPARTANBURG
Practice Address - State:SC
Practice Address - Zip Code:29303-3098
Practice Address - Country:US
Practice Address - Phone:864-560-6193
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-06-15
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SCLL40712207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine