Provider Demographics
NPI:1497791479
Name:DARDEN, KEVIN LEE (CHIROPRACTER)
Entity Type:Individual
Prefix:DR
First Name:KEVIN
Middle Name:LEE
Last Name:DARDEN
Suffix:
Gender:M
Credentials:CHIROPRACTER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5119 E KELLOGG DR
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67218-1625
Mailing Address - Country:US
Mailing Address - Phone:316-685-0020
Mailing Address - Fax:316-686-3278
Practice Address - Street 1:5119 E KELLOGG DR
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67218-1625
Practice Address - Country:US
Practice Address - Phone:316-685-0020
Practice Address - Fax:316-686-3278
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-06-20
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS01-04612111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS060984Medicare UPIN