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NPI Code Detail

MEDICARE: LAURA A. KINKEAD, D.C., PA

MEDICARE: LAURA A. KINKEAD, D.C., 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
1111NN1001XNutrition Chiropractor

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number : 1164722427
Entity Type Code : Organization
Provider Name (Legal Business Name) : LAURA A. KINKEAD, D.C., PA
Provider Business Mailing Address
First Line : 6145 GRAND BLVD
Second Line :
City : NEW PORT RICHEY
State : FL
Zip : 34652-2605
Country : US
Telephone Number : 727-849-5077
Fax Number : 727-849-7901
Provider Business Practice Location Address
First Line : 6145 GRAND BLVD
Second Line :
City : NEW PORT RICHEY
State : FL
Zip : 34652-2605
Country : US
Telephone Number : 727-849-5077
Fax Number : 727-849-7901
Authorized Official
Title or Position : PRESIDENT
Name : DR. LAURA ANN KINKEAD
Credential : D.C.
Telephone Number : 727-849-5077
Provider Enumeration Date : 11/02/2010
Last Update Date : 11/02/2010

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