Provider Demographics
NPI:1760491922
Name:HOWELL, KEVIN K (DO)
Entity Type:Individual
Prefix:
First Name:KEVIN
Middle Name:K
Last Name:HOWELL
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2373 G RD
Mailing Address - Street 2:
Mailing Address - City:GRAND JUNCTION
Mailing Address - State:CO
Mailing Address - Zip Code:81505-9641
Mailing Address - Country:US
Mailing Address - Phone:970-242-2429
Mailing Address - Fax:970-242-2337
Practice Address - Street 1:2373 G RD
Practice Address - Street 2:
Practice Address - City:GRAND JUNCTION
Practice Address - State:CO
Practice Address - Zip Code:81505-9641
Practice Address - Country:US
Practice Address - Phone:970-242-2429
Practice Address - Fax:970-242-2337
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-05
Last Update Date:2014-04-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COCO34557207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO01345578Medicaid
C474538Medicare PIN