Provider Demographics
NPI:1821301524
Name:MCCARTER, KEVIN D
Entity Type:Individual
Prefix:
First Name:KEVIN
Middle Name:D
Last Name:MCCARTER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2518 RIDGE CT STE 238
Mailing Address - Street 2:
Mailing Address - City:LAWRENCE
Mailing Address - State:KS
Mailing Address - Zip Code:66046-4061
Mailing Address - Country:US
Mailing Address - Phone:785-760-2176
Mailing Address - Fax:785-749-0103
Practice Address - Street 1:2518 RIDGE CT STE 238
Practice Address - Street 2:
Practice Address - City:LAWRENCE
Practice Address - State:KS
Practice Address - Zip Code:66046-4061
Practice Address - Country:US
Practice Address - Phone:785-760-2176
Practice Address - Fax:785-749-0103
Is Sole Proprietor?:No
Enumeration Date:2010-07-22
Last Update Date:2010-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator