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General NPI Number Information
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NPI Number | 1861550667
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Entity Type | Individual
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Provider Name | DAVID LOUIS KIRSCHKE MD
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Gender | Male
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Dates
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Enumeration Date | 12/05/2006
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Last Update Date | 10/05/2011
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Provider Practice Location Address
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Address Line | 1233 SOUTHWEST AVE
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City | JOHNSON CITY
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State | TN
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Zip | 37604-6596
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Country | US
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Telephone | 423-979-3200
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Fax | 423-979-3267
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Provider Business Mailing Address
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Address Line | 729 W LOCUST ST
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City | JOHNSON CITY
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State | TN
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Zip | 37604-6503
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Country | US
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Telephone | 423-914-0840
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Fax |
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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 | MDF37315
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License Number State | TN
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