Niebaum, Kevin K.

Niebaum, Kevin K. is an sole proprietor health care provider with primary practice located at 306 Corder Rd Suite 1, Warner Robins GA 31088-3647. He recently has only one registered license in Allopathic & Osteopathic Physicians / Pediatrics, which is considered as his primary health care specialty. Niebaum, Kevin K. can be contacted via phone (478) 922-3074.

Contact Information

Primary practice address
306 Corder Rd Suite 1 Warner Robins GA 31088-3647
Phone: (478) 922-3074
Fax: (478) 922-3076
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Pediatrics 208000000X 047353 Georgia

Profile Details

NPI number 1760449383
LBN Legal business name Niebaum, Kevin K.
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Apr 27th, 2006
Last updated Jul 23rd, 2008 - about 18 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1760449383 NPPES
Georgia MEDICAID 000834809D

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