Provider Demographics
NPI:1922171891
Name:HARVEY, ROY KEVIN (DC)
Entity Type:Individual
Prefix:
First Name:ROY
Middle Name:KEVIN
Last Name:HARVEY
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:RT 1 BOX 104
Mailing Address - Street 2:
Mailing Address - City:UNION
Mailing Address - State:WV
Mailing Address - Zip Code:24983
Mailing Address - Country:US
Mailing Address - Phone:304-832-6420
Mailing Address - Fax:304-832-6430
Practice Address - Street 1:RT 1 BOX 104
Practice Address - Street 2:
Practice Address - City:UNION
Practice Address - State:WV
Practice Address - Zip Code:24983
Practice Address - Country:US
Practice Address - Phone:304-832-6420
Practice Address - Fax:304-832-6430
Is Sole Proprietor?:No
Enumeration Date:2006-11-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV603111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
WV000535143OtherBLUE CROSS BLUE SHIELD
WV0132175000Medicaid
WV4653070OtherAETNA
WV4653070OtherAETNA
WVHA0807171Medicare ID - Type Unspecified