| Doctor Name: | KEVIN GEORGE |
| NPI Number: | 1104808674 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | |
| License Number: | 010847 |
| Business Practice Address: | 1001 E 2nd St Coudersport, PA - 169158161 |
| Business Phone Number: | 8142740900 |
| Business Fax Number: | |
| Mailing Address: | 2852 Bells Run Rd, SHINGLEHOUSE |
| State: | PA |
| Postal Code: | 167483036 |
| Phone Number: | 8142604527 |
| Fax Number: | |
| NPI Enumeration Date: | 11/18/2005 |
| NPI Last Update Date: | 12/04/2008 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 363AM0700X |
| License Number: | 010847 |
| Healthcare Provider Taxonomy: (Secondary) | N |
| State: | NY |
| Taxonomy Type: | Physician Assistants & Advanced Practice Nursing Providers |
| Taxonomy Classification: | Physician Assistant |
| Taxonomy Specialization: | Medical |
| Taxonomy Definition: | |