Provider Demographics
NPI:1609192483
Name:NOEL, KEVIN JAMES (DC)
Entity Type:Individual
Prefix:DR
First Name:KEVIN
Middle Name:JAMES
Last Name:NOEL
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1330 N INTERSTATE DR
Mailing Address - Street 2:
Mailing Address - City:NORMAN
Mailing Address - State:OK
Mailing Address - Zip Code:73072-3393
Mailing Address - Country:US
Mailing Address - Phone:405-366-9355
Mailing Address - Fax:405-366-9393
Practice Address - Street 1:1330 N INTERSTATE DR
Practice Address - Street 2:
Practice Address - City:NORMAN
Practice Address - State:OK
Practice Address - Zip Code:73072-3393
Practice Address - Country:US
Practice Address - Phone:405-366-9355
Practice Address - Fax:405-366-9393
Is Sole Proprietor?:No
Enumeration Date:2010-04-19
Last Update Date:2015-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA007227111N00000X
OK4182111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor