MEDICARE: KEVIN HUNG DC

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
1	111N00000X	Chiropractor	1282	MS
2	111N00000X	Chiropractor	B01774	NV

General Provider Information

NPI Number	:	1386144301
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KEVIN HUNG DC

Provider Business Mailing Address
First Line	:	6942 AUTUMN OAKS DR STE A
Second Line	:
City	:	OLIVE BRANCH
State	:	MS
Zip	:	38654-9379
Country	:	US
Telephone Number	:
Fax Number	:

Provider Business Practice Location Address
First Line	:	3820 W ANN RD STE 130
Second Line	:
City	:	NORTH LAS VEGAS
State	:	NV
Zip	:	89031-4401
Country	:	US
Telephone Number	:	702-233-2626
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	02/16/2018
Last Update Date	:	07/09/2019

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Directions to “ KEVIN HUNG DC” Practice Location

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