Provider Demographics
NPI:1972867638
Name:LOUGEE, KEVIN MICHAEL (DO)
Entity Type:Individual
Prefix:DR
First Name:KEVIN
Middle Name:MICHAEL
Last Name:LOUGEE
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 1:2825 E DISTRICT ST
Mailing Address - Street 2:
Mailing Address - City:TUCSON
Mailing Address - State:AZ
Mailing Address - Zip Code:85714-2081
Mailing Address - Country:US
Mailing Address - Phone:520-724-8600
Mailing Address - Fax:520-724-8610
Practice Address - Street 1:2825 E DISTRICT ST
Practice Address - Street 2:
Practice Address - City:TUCSON
Practice Address - State:AZ
Practice Address - Zip Code:85714-2081
Practice Address - Country:US
Practice Address - Phone:520-724-8600
Practice Address - Fax:520-724-8610
Is Sole Proprietor?:No
Enumeration Date:2012-06-27
Last Update Date:2016-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZR2131207ZP0102X
CO390200000X
AZ006593207ZF0201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207ZF0201XAllopathic & Osteopathic PhysiciansPathologyForensic Pathology
No207ZP0102XAllopathic & Osteopathic PhysiciansPathologyAnatomic Pathology & Clinical Pathology
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program