Wilson, Kelly Martin

Wilson, Kelly Martin is an individual health care provider with primary practice located at 1330 Boiling Springs Rd Suite 1600, Spartanburg SC 29303-4201. She recently has only one registered license in Physician Assistants & Advanced Practice Nursing Providers / Medical, which is considered as her primary health care specialty. Wilson, Kelly Martin can be contacted via phone (864) 582-6396.

Contact Information

Primary practice address
1330 Boiling Springs Rd Suite 1600 Spartanburg SC 29303-4201
Phone: (864) 582-6396
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Physician Assistants & Advanced Practice Nursing Providers / Medical 363AM0700X 1237 South Carolina

Profile Details

NPI number 1396933461
LBN Legal business name Wilson, Kelly Martin
Credentials Physician's Assistant Certified (PA-C)
Entity Individual
Sole proprietor 1 No
Enumeration date Oct 13th, 2007
Last updated Nov 9th, 2012 - about 14 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 1396933461 NPPES
South Carolina MEDICAID 0886PA

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