MEDICARE: DR. BRIAN NICHOLAS KACHERIS 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	207Q00000X	Family Medicine Physician	102192	GA
2	390200000X	Student in an Organized Health Care Education/Training Program
3	207Q00000X	Family Medicine Physician	ME166313	FL

General Provider Information

NPI Number	:	1922633023
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. BRIAN NICHOLAS KACHERIS MD

Provider Business Mailing Address
First Line	:	1301 HODGES DR
Second Line	:
City	:	TALLAHASSEE
State	:	FL
Zip	:	32308-4614
Country	:	US
Telephone Number	:	850-431-5430
Fax Number	:

Provider Business Practice Location Address
First Line	:	1115 W CALL ST
Second Line	:
City	:	TALLAHASSEE
State	:	FL
Zip	:	32304-3556
Country	:	US
Telephone Number	:	850-644-1855
Fax Number	:

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

Provider Enumeration Date	:	03/09/2020
Last Update Date	:	02/24/2025

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