Healthcare Provider Details

I. General information

NPI: 1619923729
Provider Name (Legal Business Name): GEORGE B. KEHLER II M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/26/2006
Last Update Date: 06/11/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1420 TUSCULUM BLVD
GREENEVILLE TN
37745
US

IV. Provider business mailing address

PO BOX 634706
CINCINNATI OH
45263-0001
US

V. Phone/Fax

Practice location:
  • Phone: 423-787-5000
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code208M00000X
TaxonomyHospitalist Physician
License NumberMD24072
License Number StateTN
# 2
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License NumberMD24072
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: