Provider Demographics
NPI:1598750523
Name:MYERS, KEVIN J (MD)
Entity type:Individual
Prefix:MR
First Name:KEVIN
Middle Name:J
Last Name:MYERS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:3841 GREEN HILLS VILLAGE DR STE 200
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37215-2691
Mailing Address - Country:US
Mailing Address - Phone:615-936-2000
Mailing Address - Fax:
Practice Address - Street 1:VANDERBILT UNIVERSITY
Practice Address - Street 2:1161 21ST AVENUE SOUTH, T-3219 MCN
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37232-0001
Practice Address - Country:US
Practice Address - Phone:615-322-4746
Practice Address - Fax:615-322-6248
Is Sole Proprietor?:No
Enumeration Date:2005-09-15
Last Update Date:2022-03-30
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TNMD0000017960207RR0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RR0500XAllopathic & Osteopathic PhysiciansInternal MedicineRheumatology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3033838Medicaid
TN660004021OtherRAILROAD MEDICARE
TN3033831Medicare PIN
TN3033838Medicaid