Provider Demographics
NPI:1760824981
Name:QUINN, KEVIN JEROME (RPA)
Entity Type:Individual
Prefix:MR
First Name:KEVIN
Middle Name:JEROME
Last Name:QUINN
Suffix:
Gender:M
Credentials:RPA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8920 MOSSY OAK DR
Mailing Address - Street 2:
Mailing Address - City:GAINESVILLE
Mailing Address - State:GA
Mailing Address - Zip Code:30506-4032
Mailing Address - Country:US
Mailing Address - Phone:770-403-5378
Mailing Address - Fax:
Practice Address - Street 1:8920 MOSSY OAK DR
Practice Address - Street 2:
Practice Address - City:GAINESVILLE
Practice Address - State:GA
Practice Address - Zip Code:30506-4032
Practice Address - Country:US
Practice Address - Phone:770-403-5378
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-07-30
Last Update Date:2013-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes243U00000XTechnologists, Technicians & Other Technical Service ProvidersRadiology Practitioner Assistant