Kickham, Thomas C.

Kickham, Thomas C. is an individual health care provider with primary practice located at 200 Booker Dr , Walhalla SC 29691-2278. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Emergency Medicine, Allopathic & Osteopathic Physicians / General Practice. Allopathic & Osteopathic Physicians / General Practice is his primary health care specialty. Kickham, Thomas C. can be contacted via phone (864) 656-3076.

Contact Information

Primary practice address
200 Booker Dr Walhalla SC 29691-2278
Phone: (864) 656-3076
Fax: (843) 985-9562
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Emergency Medicine 207P00000X 241 South Carolina
Allopathic & Osteopathic Physicians / General Practice 208D00000X 241 South Carolina

Profile Details

NPI number 1669434437
LBN Legal business name Kickham, Thomas C.
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 5th, 2006
Last updated Dec 13th, 2023 - about 2 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 1669434437 NPPES
Georgia MEDICAID 000925306A
Georgia MEDICAID 002419
Georgia MEDICAID 89066G1

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