Provider Demographics
NPI:1861070708
Name:MCGEORGE, KEVIN JACOB (DO)
Entity type:Individual
Prefix:DR
First Name:KEVIN
Middle Name:JACOB
Last Name:MCGEORGE
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Gender:M
Credentials:DO
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Mailing Address - Street 1:1 UNIVERSITY OF NEW MEXICO
Mailing Address - Street 2:MSC10 5550
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87131-0001
Mailing Address - Country:US
Mailing Address - Phone:505-272-6331
Mailing Address - Fax:505-272-0475
Practice Address - Street 1:1 UNIVERSITY OF NEW MEXICO
Practice Address - Street 2:MSC10 5550
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87131-0001
Practice Address - Country:US
Practice Address - Phone:505-272-6331
Practice Address - Fax:505-272-0475
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-31
Last Update Date:2024-08-21
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Provider Licenses
StateLicense IDTaxonomies
NMDO2024-0030207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine