Individual
KEVIN BIRD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Contact information
Practice address
493 WESTFIELD RD STE A, NOBLESVILLE, IN 46060-1304
(317) 770-4100
(317) 770-4105
Mailing address
8751 JAFFA COURT EAST DR APT 11, INDIANAPOLIS, IN 46260-2398
(317) 308-0644
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
10002542A
IN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
300017857
—
IN
Enumeration date
05/11/2018
Last updated
04/05/2019
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