Provider Demographics
NPI:1023078011
Name:ARD, KEVIN ALLEN (PA)
Entity type:Individual
Prefix:MR
First Name:KEVIN
Middle Name:ALLEN
Last Name:ARD
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:830 LAURENS ST
Mailing Address - Street 2:
Mailing Address - City:AIKEN
Mailing Address - State:SC
Mailing Address - Zip Code:29801-3416
Mailing Address - Country:US
Mailing Address - Phone:706-595-7652
Mailing Address - Fax:706-564-6953
Practice Address - Street 1:830 LAURENS ST
Practice Address - Street 2:
Practice Address - City:AIKEN
Practice Address - State:SC
Practice Address - Zip Code:29801-3416
Practice Address - Country:US
Practice Address - Phone:803-641-8000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-03-24
Last Update Date:2023-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC6252255A2300X
SCPA1568363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
No2255A2300XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersSpecialist/TechnologistAthletic Trainer