Provider Demographics
NPI:1881657369
Name:HOWARD, KEVIN GEORGE (DC)
Entity Type:Individual
Prefix:DR
First Name:KEVIN
Middle Name:GEORGE
Last Name:HOWARD
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 1:3103 W STOLLEY PARK RD
Mailing Address - Street 2:SUITE 102
Mailing Address - City:GRAND ISLAND
Mailing Address - State:NE
Mailing Address - Zip Code:68801-7228
Mailing Address - Country:US
Mailing Address - Phone:308-381-8171
Mailing Address - Fax:308-381-2376
Practice Address - Street 1:3103 W STOLLEY PARK RD
Practice Address - Street 2:SUITE 102
Practice Address - City:GRAND ISLAND
Practice Address - State:NE
Practice Address - Zip Code:68801-7228
Practice Address - Country:US
Practice Address - Phone:308-381-8171
Practice Address - Fax:308-381-2376
Is Sole Proprietor?:Yes
Enumeration Date:2006-04-07
Last Update Date:2011-07-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE808111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
NEP00451120OtherRAILROAD MEDICARE
NE09563OtherBCBS PROVIDER ID
NE224561OtherMIDLAND'S CHOICE PROV ID
NE41-2255613OtherFEDERAL TAX ID
NE10025573700Medicaid
NE09563OtherBCBS PROVIDER ID
NEU11673Medicare UPIN