Provider Demographics
NPI:1700869179
Name:SCRIPTURE, KEVIN T (MD)
Entity Type:Individual
Prefix:DR
First Name:KEVIN
Middle Name:T
Last Name:SCRIPTURE
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:PO BOX 399
Mailing Address - Street 2:
Mailing Address - City:RICHMOND
Mailing Address - State:IN
Mailing Address - Zip Code:47375-0399
Mailing Address - Country:US
Mailing Address - Phone:765-966-1945
Mailing Address - Fax:765-966-2975
Practice Address - Street 1:1900 CHESTER BLVD
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:IN
Practice Address - Zip Code:47374-1213
Practice Address - Country:US
Practice Address - Phone:765-962-2020
Practice Address - Fax:765-966-2975
Is Sole Proprietor?:No
Enumeration Date:2005-11-21
Last Update Date:2011-10-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01044003207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2077532Medicaid
IN200180470Medicaid
OH0886891Medicare PIN
OH2077532Medicaid
IN263670GMedicare PIN
OHP00968329Medicare PIN