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NPI Code Detail

MEDICARE: KENNETH CAZORT

MEDICARE:   KENNETH  CAZORT
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
12084B0040XBehavioral Neurology & Neuropsychiatry Physician42056TN
22084P0804XChild & Adolescent Psychiatry Physician42056TN
32084P0805XGeriatric Psychiatry Physician42056TN
42084P0800XPsychiatry Physician42056TN

General Provider Information

NPI Number : 1467380907
Entity Type Code : Individual
Provider Name (Legal Business Name) : KENNETH CAZORT
Provider Business Mailing Address
First Line : 8212 HARBOUR CHASE LOOP
Second Line :
City : OOLTEWAH
State : TN
Zip : 37363-2578
Country : US
Telephone Number : 478-951-9069
Fax Number :
Provider Business Practice Location Address
First Line : 8212 HARBOUR CHASE LOOP
Second Line :
City : OOLTEWAH
State : TN
Zip : 37363-2578
Country : US
Telephone Number : 478-951-9069
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/13/2026
Last Update Date : 05/13/2026

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Directions to “ KENNETH CAZORT ” Practice Location

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