Formes, Kevin John

Formes, Kevin John is an individual health care provider with primary practice located at 1002 Texas Blvd Suite 401, Texarkana TX 75501-5107. He recently has only one registered license in Allopathic & Osteopathic Physicians / Interventional Cardiology, which is considered as his primary health care specialty. Formes, Kevin John can be contacted via phone (903) 794-8820.

Contact Information

Primary practice address
1002 Texas Blvd Suite 401 Texarkana TX 75501-5107
Phone: (903) 794-8820
Fax: (903) 794-8878
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Interventional Cardiology 207RI0011X M0077 Texas

Profile Details

NPI number 1497878474
LBN Legal business name Formes, Kevin John
Credentials Doctor of Osteopathy (DO)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 6th, 2007
Last updated Nov 4th, 2015 - about 9 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1497878474 NPPES
Arkansas MEDICAID 182168003
Arkansas MEDICAID 211561001
Arkansas Other P00836010
Arkansas MEDICAID 200287540A

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