MEDICARE: SCOTT KERCHEVILLE, MD, 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
1	207L00000X	Anesthesiology Physician	G5247	TX

General Provider Information

NPI Number	:	1669883815
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SCOTT KERCHEVILLE, MD, PA

Provider Business Mailing Address
First Line	:	14 ETON GREEN CIR
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78257-1633
Country	:	US
Telephone Number	:	210-698-2015
Fax Number	:

Provider Business Practice Location Address
First Line	:	14 ETON GREEN CIR
Second Line	:
City	:	SAN ANTONIO
State	:	TX
Zip	:	78257-1633
Country	:	US
Telephone Number	:	210-698-2015
Fax Number	:

Authorized Official
Title or Position	:	OWNER/PRESIDENT
Name	:	SCOTT E KERCHEVILLE
Credential	:	MD
Telephone Number	:	210-698-2015

Provider Enumeration Date	:	05/09/2014
Last Update Date	:	05/10/2014

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