Blackmon, Kevin Neely

Blackmon, Kevin Neely is an individual health care provider with primary practice located at 1210 W Faris Rd , Greenville SC 29605. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Diagnostic Radiology, Allopathic & Osteopathic Physicians / Vascular & Interventional Radiology. Allopathic & Osteopathic Physicians / Diagnostic Radiology is his primary health care specialty. Blackmon, Kevin Neely can be contacted via phone (864) 522-1800.

Contact Information

Primary practice address
1210 W Faris Rd Greenville SC 29605
Phone: (864) 522-1800
Fax: (864) 522-1806
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Diagnostic Radiology 2085R0202X 31776 South Carolina
Allopathic & Osteopathic Physicians / Vascular & Interventional Radiology 2085R0204X 2031776 South Carolina

Profile Details

NPI number 1679700140
LBN Legal business name Blackmon, Kevin Neely
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Jun 11th, 2009
Last updated Dec 6th, 2021 - about 3 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 1679700140 NPPES
South Carolina MEDICAID 317767

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