Provider Demographics
NPI:1548580392
Name:LOK, KEVIN (MD)
Entity Type:Individual
Prefix:DR
First Name:KEVIN
Middle Name:
Last Name:LOK
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:738 SUTTER LN SE # E202
Mailing Address - Street 2:
Mailing Address - City:OLYMPIA
Mailing Address - State:WA
Mailing Address - Zip Code:98503-1472
Mailing Address - Country:US
Mailing Address - Phone:347-556-0118
Mailing Address - Fax:
Practice Address - Street 1:600 BARNES BLVD.
Practice Address - Street 2:MCCHORD MEDICAL CLINIC
Practice Address - City:JBLM
Practice Address - State:WA
Practice Address - Zip Code:98438
Practice Address - Country:US
Practice Address - Phone:253-962-7103
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2010-06-03
Last Update Date:2020-01-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE26608207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine