Individual
DR. KEVIN M. MCCANN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
90 JACKSON PIKE, GALLIPOLIS, OH 45631-1560
(740) 446-5890
(740) 446-5532
Mailing address
90 JACKSON PIKE, GALLIPOLIS, OH 45631-1560
(740) 446-5890
(740) 446-5532
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
35-055217
OH
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
000000190735
UNISON MEDICAID
OH
01
—
000000359015
ANTHEM BCBS
—
01
—
1275571564
NPI
—
01
—
2545982
MOLINA MEDICAID
OH
05
—
3810001649
—
WV
01
—
P00203692
RR MEDICARE
—
Enumeration date
06/02/2006
Last updated
08/27/2007
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