Kickliter, David J

Kickliter, David J is an individual health care provider with primary practice located at 407 4Th St , Newport TN 37821-3755. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Kickliter, David J can be contacted via phone (423) 623-6240.

Contact Information

Primary practice address
407 4Th St Newport TN 37821-3755
Phone: (423) 623-6240
Fax: (423) 623-0102
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Family Medicine 207Q00000X 17859 Tennessee

Profile Details

NPI number 1609850569
LBN Legal business name Kickliter, David J
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 No
Enumeration date Dec 5th, 2005
Last updated Nov 6th, 2013 - about 11 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1609850569 NPPES
Tennessee MEDICAID 3028740

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