Provider Demographics
NPI:1144341785
Name:EMGE, KEVIN RAY (DO)
Entity type:Individual
Prefix:DR
First Name:KEVIN
Middle Name:RAY
Last Name:EMGE
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:8704 HARNEY ST
Mailing Address - Street 2:
Mailing Address - City:OMAHA
Mailing Address - State:NE
Mailing Address - Zip Code:68114-4008
Mailing Address - Country:US
Mailing Address - Phone:402-991-0336
Mailing Address - Fax:
Practice Address - Street 1:984455 NEBRASKA MEDICAL CTR
Practice Address - Street 2:
Practice Address - City:OMAHA
Practice Address - State:NE
Practice Address - Zip Code:68198-4455
Practice Address - Country:US
Practice Address - Phone:402-559-7405
Practice Address - Fax:402-559-7372
Is Sole Proprietor?:No
Enumeration Date:2007-04-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE5141207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology