Basic Information
Provider Information
NPI: 1649462771
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: KERR
FirstName: PAUL
MiddleName:  
NamePrefix: DR.
NameSuffix:  
Credential: D.O.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 6439 GARNERS FERRY RD
Address2:  
City: COLUMBIA
State: SC
PostalCode: 29202
CountryCode: US
TelephoneNumber: 8037764000
FaxNumber:  
Practice Location
Address1: 6439 GARNERS FERRY RD
Address2:  
City: COLUMBIA
State: SC
PostalCode: 29202
CountryCode: US
TelephoneNumber: 8037764000
FaxNumber:  
Other Information
ProviderEnumerationDate: 08/13/2007
LastUpdateDate: 04/21/2017
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: Y
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
2086S0127X072309GAY Allopathic & Osteopathic PhysiciansSurgeryTrauma Surgery

No ID Information.


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