Provider Demographics
NPI:1104043090
Name:HOWARD, KEVIN (DO)
Entity Type:Individual
Prefix:
First Name:KEVIN
Middle Name:
Last Name:HOWARD
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 2155
Mailing Address - Street 2:
Mailing Address - City:ASHLAND
Mailing Address - State:KY
Mailing Address - Zip Code:41105-2155
Mailing Address - Country:US
Mailing Address - Phone:606-928-1881
Mailing Address - Fax:606-928-1776
Practice Address - Street 1:2420 ARGILLITE RD
Practice Address - Street 2:
Practice Address - City:FLATWOODS
Practice Address - State:KY
Practice Address - Zip Code:41139-1972
Practice Address - Country:US
Practice Address - Phone:606-836-3900
Practice Address - Fax:606-836-0205
Is Sole Proprietor?:No
Enumeration Date:2007-04-20
Last Update Date:2010-05-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KYKY03037207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY000000606886OtherANTHEM BCBS
KY000000522005OtherANTHEM BCBS
OH2763326Medicaid
KY000000650578OtherANTHEM BCBS
KY7100013740Medicaid
KY000000653083OtherANTHEM BCBS
KY01258002Medicare PIN
KY000000650578OtherANTHEM BCBS
KY7100013740Medicaid
KYP00699954Medicare PIN
KY0643021Medicare PIN
KY00953002Medicare PIN
KY00749005Medicare PIN