National Provider Identifier Database

KEVIN R KICKHAM LLC
Optometrist

Doctors of optometry (ODs) are the primary health care professionals for the eye. Optometrists examine, diagnose, treat, and manage diseases, injuries, and disorders of the visual system, the eye, and associated structures as well as identify related systemic conditions affecting the eye.


Contact Information

KEVIN R KICKHAM LLC
1308 E BATTLEFIELD
SPRINGFIELD, MO65804
Phone: 417-890-7599
Fax: 417-886-6484
Website:
Specialty Taxonomy Code
* Optometrist 152W00000X

* Indicates primary specialty

NPI Profile & details for KEVIN R KICKHAM LLC

NPI Number 1548476344
Legal business name
LBN
KEVIN R KICKHAM LLC
Authorized official KEVIN KICKHAM - (OPTOMETRIST OWNER)
Entity Organization
Organization subpart No
Enumeration date 05/16/2007
Last updated 02/05/2016 - About 10 years ago
Sole proprietor1 Not specified
Identifiers
  • MO License #: T02770
  • MO Medicaid: 315387803
  • MO Other: 000014298 MEDICARE PTAN
  • MO Other: P00256828 RAILROAD MEDICARE

1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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