Provider Demographics
NPI:1235118779
Name:JOSEPH KAVCHOK JR. M.D. P.C.
Entity Type:Organization
Organization Name:JOSEPH KAVCHOK JR. M.D. P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:JOSEPH
Authorized Official - Middle Name:
Authorized Official - Last Name:KAVCHOK
Authorized Official - Suffix:JR
Authorized Official - Credentials:MD
Authorized Official - Phone:610-421-8470
Mailing Address - Street 1:319 MAIN ST
Mailing Address - Street 2:
Mailing Address - City:EMMAUS
Mailing Address - State:PA
Mailing Address - Zip Code:18049-2704
Mailing Address - Country:US
Mailing Address - Phone:610-421-8470
Mailing Address - Fax:610-421-8490
Practice Address - Street 1:319 MAIN ST
Practice Address - Street 2:
Practice Address - City:EMMAUS
Practice Address - State:PA
Practice Address - Zip Code:18049-2704
Practice Address - Country:US
Practice Address - Phone:610-421-8470
Practice Address - Fax:610-421-8490
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-12
Last Update Date:2016-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAE64095Medicare UPIN
PA434963Medicare PIN