Provider Demographics
NPI:1942294129
Name:CULBERT, KEVIN EUGENE (DO)
Entity Type:Individual
Prefix:
First Name:KEVIN
Middle Name:EUGENE
Last Name:CULBERT
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 1:607 E JUBAL EARLY DR
Mailing Address - Street 2:
Mailing Address - City:WINCHESTER
Mailing Address - State:VA
Mailing Address - Zip Code:22601-5178
Mailing Address - Country:US
Mailing Address - Phone:540-536-2200
Mailing Address - Fax:540-665-5289
Practice Address - Street 1:607 E JUBAL EARLY DR
Practice Address - Street 2:
Practice Address - City:WINCHESTER
Practice Address - State:VA
Practice Address - Zip Code:22601-5178
Practice Address - Country:US
Practice Address - Phone:540-536-2200
Practice Address - Fax:540-665-5289
Is Sole Proprietor?:No
Enumeration Date:2005-09-02
Last Update Date:2021-03-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WV3173207Q00000X
IA3479207Q00000X
VA0102201411207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine