Provider Demographics
NPI:1366822488
Name:HA, KEVIN HOAG YOUL (MD, PHD)
Entity Type:Individual
Prefix:
First Name:KEVIN
Middle Name:HOAG YOUL
Last Name:HA
Suffix:
Gender:M
Credentials:MD, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:600 GRESHAM DR STE 8610
Mailing Address - Street 2:
Mailing Address - City:NORFOLK
Mailing Address - State:VA
Mailing Address - Zip Code:23507-1904
Mailing Address - Country:US
Mailing Address - Phone:757-252-9015
Mailing Address - Fax:757-510-9041
Practice Address - Street 1:600 GRESHAM DR STE 8610
Practice Address - Street 2:
Practice Address - City:NORFOLK
Practice Address - State:VA
Practice Address - Zip Code:23507-1904
Practice Address - Country:US
Practice Address - Phone:757-252-9015
Practice Address - Fax:757-510-9041
Is Sole Proprietor?:No
Enumeration Date:2015-06-03
Last Update Date:2024-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2022-020092084N0400X
390200000X
VA01012724152084N0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2084N0400XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyNeurology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program