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NPI Code Detail

MEDICARE: KEVIN KUSCH PA

MEDICARE:   KEVIN  KUSCH  PA
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363A00000XPhysician AssistantPA01209TX

General Provider Information

NPI Number : 1538164389
Entity Type Code : Individual
Provider Name (Legal Business Name) : KEVIN KUSCH PA
Provider Business Mailing Address
First Line : 5239 FM 1649
Second Line :
City : GILMER
State : TX
Zip : 75645-6541
Country : US
Telephone Number : 903-797-2088
Fax Number : 903-797-2128
Provider Business Practice Location Address
First Line : 408 QUITMAN ST
Second Line :
City : PITTSBURG
State : TX
Zip : 75686-1032
Country : US
Telephone Number : 903-856-4242
Fax Number : 903-856-4244
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/17/2005
Last Update Date : 07/08/2007

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Directions to “ KEVIN KUSCH PA” Practice Location

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