Crutcher, Kenneth L

Crutcher, Kenneth L is an individual health care provider with primary practice located at 4303 Live Oak Dr , Little River SC 29566-9138. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Crutcher, Kenneth L can be contacted via phone (843) 663-8000.

Contact Information

Primary practice address
4303 Live Oak Dr Little River SC 29566-9138
Phone: (843) 663-8000
Fax: (843) 280-2455
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 29550 North Carolina
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X MMD33307 South Carolina

Profile Details

NPI number 1063473320
LBN Legal business name Crutcher, Kenneth L
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Mar 28th, 2006
Last updated Sep 23rd, 2013 - about 13 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1063473320 NPPES
North Carolina MEDICAID 8926422
North Carolina Other 26422

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