Provider Demographics
NPI:1447228994
Name:KITCHIN, ALVIN P JR (MD)
Entity Type:Individual
Prefix:DR
First Name:ALVIN
Middle Name:P
Last Name:KITCHIN
Suffix:JR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 473
Mailing Address - Street 2:
Mailing Address - City:WADESBORO
Mailing Address - State:NC
Mailing Address - Zip Code:28170-0473
Mailing Address - Country:US
Mailing Address - Phone:704-694-5188
Mailing Address - Fax:704-694-9067
Practice Address - Street 1:110 E ASHE ST
Practice Address - Street 2:
Practice Address - City:WADESBORO
Practice Address - State:NC
Practice Address - Zip Code:28170-2702
Practice Address - Country:US
Practice Address - Phone:704-694-5188
Practice Address - Fax:704-694-9067
Is Sole Proprietor?:No
Enumeration Date:2006-03-10
Last Update Date:2014-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC13478207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC8949595Medicaid
SCN287840Medicaid
NC8949595Medicaid
NCC88580Medicare UPIN
SCN287840Medicaid