Kevin R Kickham Llc

LBN: Kevin R Kickham Llc
Kevin R Kickham Llc is an health care organization with primary practice located at 1308 E Battlefield , Springfield MO 65804. The organization recently has only one registered license in Eye and Vision Services Providers / Optometrist, which is considered as the primary health care specialty. Kevin R Kickham Llc can be contacted via phone (417) 890-7599, or through Kickham, Kevin Robert via phone (417) 890-7599.

Contact Information

Primary practice address
1308 E Battlefield Springfield MO 65804
Phone: (417) 890-7599
Fax: (417) 886-6484
Website:
Map and Directions
Authorized official contact:
Name: Kickham, Kevin Robert Doctor of Optometry (OD)
Phone: (417) 890-7599

Health care specialties

SpecialtyCodeLicense #State
Eye and Vision Services Providers / Optometrist 152W00000X T02770 Missouri

Profile Details

NPI number 1548476344
LBN Legal business name Kevin R Kickham Llc
DBA Doing business as
Authorized official Kickham, Kevin Robert Doctor of Optometry (OD)
Entity Organization
Organization subpart 1 No
Enumeration date May 16th, 2007
Last updated Feb 5th, 2016 - about 10 years ago

1 Some organizations, which are providing health care services, may consist of units or departments that provide different types of health care services or have several separate physical locations, where health care service is provided. These units, departments or physical locations are not themselves legal entities. However, each of them is part of the organization, which is a legal entity. The organization may decide whether its subparts, if it has any, should have their own NPI numbers. In case a subpart conducts any HIPAA standard transactions by itself, without its parent's involvement, it must have its own NPI number.

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Identifiers

StateTypeNumberIssuer
All States NPI 1548476344 NPPES
Missouri MEDICAID 315387803
Missouri Other P00256828
Missouri Other 000014298

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