Provider Demographics
NPI:1215990452
Name:CALE, KEVIN GENE (PT)
Entity type:Individual
Prefix:MR
First Name:KEVIN
Middle Name:GENE
Last Name:CALE
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3549 W MEMORIAL RD
Mailing Address - Street 2:
Mailing Address - City:OKLAHOMA CITY
Mailing Address - State:OK
Mailing Address - Zip Code:73134-7015
Mailing Address - Country:US
Mailing Address - Phone:405-749-7950
Mailing Address - Fax:405-749-7940
Practice Address - Street 1:3549 W MEMORIAL RD
Practice Address - Street 2:
Practice Address - City:OKLAHOMA CITY
Practice Address - State:OK
Practice Address - Zip Code:73134-7015
Practice Address - Country:US
Practice Address - Phone:405-749-7950
Practice Address - Fax:405-749-7940
Is Sole Proprietor?:No
Enumeration Date:2006-04-10
Last Update Date:2011-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OKPT2366225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
OK900522326Medicare PIN
OK249601803Medicare PIN