Provider Demographics
NPI:1952486805
Name:KAUL, KIRAN K (DC)
Entity Type:Individual
Prefix:
First Name:KIRAN
Middle Name:K
Last Name:KAUL
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 1:1844 W HARVARD AVE
Mailing Address - Street 2:
Mailing Address - City:ROSEBURG
Mailing Address - State:OR
Mailing Address - Zip Code:97471-2717
Mailing Address - Country:US
Mailing Address - Phone:541-672-8831
Mailing Address - Fax:541-672-0019
Practice Address - Street 1:1844 W HARVARD AVE
Practice Address - Street 2:
Practice Address - City:ROSEBURG
Practice Address - State:OR
Practice Address - Zip Code:97471-2717
Practice Address - Country:US
Practice Address - Phone:541-672-8831
Practice Address - Fax:541-672-0019
Is Sole Proprietor?:No
Enumeration Date:2006-10-26
Last Update Date:2012-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OR27 3283111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
OR133637Medicare ID - Type Unspecified
ORU90437Medicare UPIN