Provider Demographics
NPI:1568455988
Name:HUBBARD, KEVIN P (DO)
Entity type:Individual
Prefix:DR
First Name:KEVIN
Middle Name:P
Last Name:HUBBARD
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1750 INDEPENDENCE AVE
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64106-1453
Mailing Address - Country:US
Mailing Address - Phone:816-654-7393
Mailing Address - Fax:
Practice Address - Street 1:1750 INDEPENDENCE AVE
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64106-1453
Practice Address - Country:US
Practice Address - Phone:816-654-7393
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-08-31
Last Update Date:2020-08-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS05-28154207RH0002X, 207RH0003X
MODO36829207RH0003X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
No207RH0002XAllopathic & Osteopathic PhysiciansInternal MedicineHospice and Palliative Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO11375OtherCOVENTRY
MO14344028OtherBCBS
MO4534636OtherAETNA
MO560421OtherFIRSTGURARD
MO026295099OtherBLACK LUNG
MO100014578OtherCOMMUNITY HEALTH PLAN
MO3650052OtherUHC
KS700038OtherBCBS KANSAS
MO243356409Medicaid
MO12441OtherHM CARE
MO97760OtherADVANTRA MEDICARE HMO
MO480911591029OtherCIGNA
MOD16931Medicare UPIN
MO830001981Medicare ID - Type UnspecifiedMEDICARE RR
MO3650052OtherUHC
MO243356409Medicaid