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 1:901 E 104TH ST
Mailing Address - Street 2:
Mailing Address - City:KANSAS CITY
Mailing Address - State:MO
Mailing Address - Zip Code:64131-4517
Mailing Address - Country:US
Mailing Address - Phone:816-502-8752
Mailing Address - Fax:
Practice Address - Street 1:4401 WORNALL RD
Practice Address - Street 2:
Practice Address - City:KANSAS CITY
Practice Address - State:MO
Practice Address - Zip Code:64111-3220
Practice Address - Country:US
Practice Address - Phone:816-932-0360
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2005-08-31
Last Update Date:2025-05-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO36829207R00000X
KS05-28154207RH0003X, 207RH0002X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RH0002XAllopathic & Osteopathic PhysiciansInternal MedicineHospice and Palliative Medicine
No207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & Oncology
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