Individual
KEVIN JO
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
455 LEWIS AVE, SUITE 106, MERIDEN, CT 06451-2121
(203) 886-0036
(203) 886-0072
Mailing address
2139 SILAS DEANE HWY # H, ROCKY HILL, CT 06067-2336
(860) 257-4131
(860) 257-4519
Taxonomy
Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
050624
CT
207RG0100X
Gastroenterology Physician
239729
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
008039309
—
CT
Enumeration date
08/03/2006
Last updated
06/01/2012
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