MEDICARE: DAVID KAHLBAUGH

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	374K00000X	Religious Nonmedical Practitioner

General Provider Information

NPI Number	:	1215826870
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DAVID KAHLBAUGH

Provider Business Mailing Address
First Line	:	2302 MURANO DR
Second Line	:
City	:	MURFREESBORO
State	:	TN
Zip	:	37128-1842
Country	:	US
Telephone Number	:	813-417-5811
Fax Number	:

Provider Business Practice Location Address
First Line	:	2302 MURANO DR
Second Line	:
City	:	MURFREESBORO
State	:	TN
Zip	:	37128-1842
Country	:	US
Telephone Number	:	813-417-5811
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/30/2025
Last Update Date	:	06/30/2025

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