Provider Demographics
NPI:1447286877
Name:COWGILL, KEVIN JOSEPH (DC)
Entity type:Individual
Prefix:DR
First Name:KEVIN
Middle Name:JOSEPH
Last Name:COWGILL
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:110 SCOTT FARMS BLVD
Mailing Address - Street 2:
Mailing Address - City:MARYSVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43040-7069
Mailing Address - Country:US
Mailing Address - Phone:937-642-2333
Mailing Address - Fax:937-642-2698
Practice Address - Street 1:110 SCOTT FARMS BLVD
Practice Address - Street 2:
Practice Address - City:MARYSVILLE
Practice Address - State:OH
Practice Address - Zip Code:43040-7069
Practice Address - Country:US
Practice Address - Phone:937-642-2333
Practice Address - Fax:937-642-2698
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-25
Last Update Date:2008-03-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH1346111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0838160Medicaid
4407883OtherAETNA HEALTH INSURANCE
614848OtherACN GROUP, INC.
OH31128656000OtherOHIO BUREAU OF WORKERS CO
44-80001 OHOtherUNITED HEALTH CARE
000000119437OtherANTHEM HEALTH INSURACE
OH31128656000OtherOHIO BUREAU OF WORKERS CO
OH0620991Medicare PIN