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Individual

DR. KEVIN DAVID KEAGLE

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
D.O.

Contact information

Practice address
1984 S 16TH ST STE 1, WILMINGTON, NC 28401-6674
(910) 452-8633
(901) 452-8569
Mailing address
PO BOX 15109, WILMINGTON, NC 28408-5109
(910) 392-2525
(910) 392-2827

Taxonomy

Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
2023-02548
NC

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1841308277
NC
01
NNT761A
MEDICARE
NC
Enumeration date
08/27/2006
Last updated
05/11/2026
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