1194904045 NPI number — DR. LOWELL FRANCIS KAVAN DC

Table of content: DR. LOWELL FRANCIS KAVAN DC (NPI 1194904045)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1194904045 NPI number — DR. LOWELL FRANCIS KAVAN DC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
KAVAN
Provider First Name:
LOWELL
Provider Middle Name:
FRANCIS
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
DC
Provider Gender Code:
M

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1194904045
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
05/02/2008
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
PO BOX 206
Provider Second Line Business Mailing Address:
KAVAN CHIROPRACTIC 109 EAST 2ND ST
Provider Business Mailing Address City Name:
WINTHROP
Provider Business Mailing Address State Name:
MN
Provider Business Mailing Address Postal Code:
55396-0206
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
507-647-3257
Provider Business Mailing Address Fax Number:
507-228-8091

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
109 EAST 2ND ST
Provider Second Line Business Practice Location Address:
KAVAN CHIROPRACTIC
Provider Business Practice Location Address City Name:
WINTHROP
Provider Business Practice Location Address State Name:
MN
Provider Business Practice Location Address Postal Code:
55396-0206
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
507-647-3257
Provider Business Practice Location Address Fax Number:
507-228-8091
Provider Enumeration Date:
10/29/2007

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 111N00000X , with the licence number:  2242 , registered in the state of MN ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 599227300 , issued by the state of ( MN ) . This identifiers is of the category "MEDICAID".




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