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General NPI Number Information
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NPI Number | 1114128725
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Entity Type | Individual
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Provider Name | KEILAH ISABEL GONZALEZ-BONILLA M.D.
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Gender | Female
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Dates
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Enumeration Date | 05/30/2007
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Last Update Date | 10/02/2025
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Provider Practice Location Address
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Address Line | 9546 S NORTHSHORE DR
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City | KNOXVILLE
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State | TN
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Zip | 37922-5813
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Country | US
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Telephone | 865-647-3440
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Fax | 865-647-2683
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Provider Business Mailing Address
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Address Line | 9546 S NORTHSHORE DR
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City | KNOXVILLE
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State | TN
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Zip | 37922-5813
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Country | US
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Telephone | 865-647-3440
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Fax | 865-647-2683
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | ME96511
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License Number State | FL
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Taxonomy #2
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Taxonomy Code | 207QG0300X
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Taxonomy Name | Geriatric Medicine (Family Medicine) Physician
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License Number | 45347
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License Number State | TN
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Taxonomy #3
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Taxonomy Code | 207QH0002X
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Taxonomy Name | Hospice and Palliative Medicine (Family Medicine) Physician
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License Number | 45347
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License Number State | TN
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Taxonomy #4
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 45347
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License Number State | TN
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