Provider Demographics
NPI:1720198377
Name:WESTBY, KEVIN JAMES (DC)
Entity Type:Individual
Prefix:DR
First Name:KEVIN
Middle Name:JAMES
Last Name:WESTBY
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 1:2216 EXECUTIVE DR
Mailing Address - Street 2:SUITE A
Mailing Address - City:HAMPTON
Mailing Address - State:VA
Mailing Address - Zip Code:23666-6602
Mailing Address - Country:US
Mailing Address - Phone:757-827-3210
Mailing Address - Fax:757-827-9089
Practice Address - Street 1:2216 EXECUTIVE DR
Practice Address - Street 2:SUITE A
Practice Address - City:HAMPTON
Practice Address - State:VA
Practice Address - Zip Code:23666-6602
Practice Address - Country:US
Practice Address - Phone:757-827-3210
Practice Address - Fax:757-827-9089
Is Sole Proprietor?:No
Enumeration Date:2006-08-30
Last Update Date:2012-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0104000693111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
5493526OtherAETNA
460427OtherACN
225605OtherMAMSI
VA249206OtherANTHEM BC/BS
460427OtherACN
U09769Medicare UPIN