MEDICARE: DR. KELLY A VOGEL MD

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	390200000X	Student in an Organized Health Care Education/Training Program

General Provider Information

NPI Number	:	1013563071
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. KELLY A VOGEL MD

Provider Business Mailing Address
First Line	:	719 THOMPSON LN STE 20400
Second Line	:
City	:	NASHVILLE
State	:	TN
Zip	:	37204-4600
Country	:	US
Telephone Number	:	615-936-2187
Fax Number	:	615-936-3218

Provider Business Practice Location Address
First Line	:	719 THOMPSON LN STE 20400
Second Line	:
City	:	NASHVILLE
State	:	TN
Zip	:	37204-4600
Country	:	US
Telephone Number	:	615-936-2187
Fax Number	:	615-936-3218

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

Provider Enumeration Date	:	08/15/2019
Last Update Date	:	08/22/2023

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