Provider Demographics
NPI:1063529568
Name:OMEARA, KEVIN FRANCIS (MD)
Entity type:Individual
Prefix:DR
First Name:KEVIN
Middle Name:FRANCIS
Last Name:OMEARA
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Gender:M
Credentials:MD
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Mailing Address - Street 1:190 ARROWHEAD DR
Mailing Address - Street 2:
Mailing Address - City:EVANSTON
Mailing Address - State:WY
Mailing Address - Zip Code:82930-9266
Mailing Address - Country:US
Mailing Address - Phone:307-679-8391
Mailing Address - Fax:307-783-8299
Practice Address - Street 1:190 ARROWHEAD DR
Practice Address - Street 2:
Practice Address - City:EVANSTON
Practice Address - State:WY
Practice Address - Zip Code:82930-9266
Practice Address - Country:US
Practice Address - Phone:307-679-8391
Practice Address - Fax:307-783-8299
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-23
Last Update Date:2007-07-08
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Provider Licenses
StateLicense IDTaxonomies
WY4267A207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
WYB64017Medicare UPIN