Provider Demographics
NPI:1164663266
Name:KEVIN A MOREMAN MD PSC
Entity Type:Organization
Organization Name:KEVIN A MOREMAN MD PSC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:A
Authorized Official - Last Name:MOREMAN
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:270-234-8866
Mailing Address - Street 1:2406 RING RD
Mailing Address - Street 2:
Mailing Address - City:ELIZABETHTOWN
Mailing Address - State:KY
Mailing Address - Zip Code:42701-7940
Mailing Address - Country:US
Mailing Address - Phone:270-234-8866
Mailing Address - Fax:270-234-1355
Practice Address - Street 1:2406 RING RD
Practice Address - Street 2:
Practice Address - City:ELIZABETHTOWN
Practice Address - State:KY
Practice Address - Zip Code:42701-7940
Practice Address - Country:US
Practice Address - Phone:270-234-8866
Practice Address - Fax:270-234-1355
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-03-19
Last Update Date:2009-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterologyGroup - Single Specialty