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Individual

KEVIN H EGAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
OD

Contact information

Practice address
2746 OLD US 20 W, ELKHART, IN 46514-1364
(574) 293-3545
Mailing address
2746 OLD US 20 W, ELKHART, IN 46514-1364
(574) 293-3545

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
18002412
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
P00407202
RAILROAD MEDICARE
Enumeration date
07/05/2006
Last updated
03/06/2008
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