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General NPI Number Information
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NPI Number | 1659170405
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Entity Type | Organization
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Legal Business Name | KILGORE SPINE AND JOINT PLLC
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Dates
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Enumeration Date | 03/12/2025
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Last Update Date | 10/15/2025
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Provider Practice Location Address
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Address Line | 1100 STONE RD STE 258
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City | KILGORE
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State | TX
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Zip | 75662-5495
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Country | US
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Telephone | 903-984-5522
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Fax |
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Provider Business Mailing Address
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Address Line | 1100 STONE RD STE 258
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City | KILGORE
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State | TX
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Zip | 75662-5495
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Country | US
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Telephone | 903-984-5522
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | DR. KEVIN L. MCNABB
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Credential | D.C.
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Telephone | 903-984-5522
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 111N00000X
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Taxonomy Name | Chiropractor
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 363L00000X
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Taxonomy Name | Nurse Practitioner
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License Number |
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License Number State |
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