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NPI Code Detail

MEDICARE: MR. KEVIN MAURICE DANSBY PA

MEDICARE: MR. KEVIN MAURICE DANSBY PA
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
1363A00000XPhysician AssistantPA0000001138TN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
14092111OTHERTNBCBS

General Provider Information

NPI Number : 1376548040
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. KEVIN MAURICE DANSBY PA
Provider Business Mailing Address
First Line : 7100 COMMERCE WAY
Second Line : SUITE 180
City : BRENTWOOD
State : TN
Zip : 37027-2829
Country : US
Telephone Number : 615-465-7000
Fax Number :
Provider Business Practice Location Address
First Line : 1060 PEERLESS XING NW
Second Line :
City : CLEVELAND
State : TN
Zip : 37312-3784
Country : US
Telephone Number : 423-479-4165
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/17/2005
Last Update Date : 08/18/2009

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Directions to “ MR. KEVIN MAURICE DANSBY PA” Practice Location

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