Kesterson, Gregg H.D.
Kesterson, Gregg H.D. is an sole proprietor health care provider with primary practice located at 105 Broyles Dr Suite B, Johnson City TN 37601-2542. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Addiction Medicine. Allopathic & Osteopathic Physicians / Addiction Medicine is his primary health care specialty. Kesterson, Gregg H.D. can be contacted via phone (423) 722-4000.Contact Information
Primary practice address
105 Broyles Dr Suite B
Johnson City TN 37601-2542
Phone: (423) 722-4000
Fax: (423) 722-4004
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Allopathic & Osteopathic Physicians / Internal Medicine | 207R00000X | 17126 | Tennessee |
Allopathic & Osteopathic Physicians / Addiction Medicine | 207RA0401X | 17126 | Tennessee |
Profile Details
NPI number | 1376585919 |
---|---|
LBN Legal business name | Kesterson, Gregg H.D. |
Credentials | Doctor of Medicine (MD) |
Entity | Individual |
Sole proprietor 1 | Yes |
Enumeration date | Jun 11th, 2006 |
Last updated | Nov 19th, 2016 - about 8 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1376585919 | NPPES |
Tennessee | Other | 110098564 | RR MEDICARE PIN |
Tennessee | MEDICAID | 3019399 | RR MEDICARE PIN |
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