Individual
OSCAR T KELLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
CRNA
Contact information
Practice address
975 E. THIRD STREET, CHATTANOOGA, TN 37403-2147
(423) 778-7608
(423) 778-2360
Mailing address
PO BOX 11225, CHATTANOOGA, TN 37401-2225
(423) 892-5602
(423) 892-5838
Taxonomy
Speciality
Code
Description
License number
State
163W00000X
Registered Nurse
RN083333
GA
163W00000X
Registered Nurse
RN37937
TN
367500000X
Certified Registered Nurse Anesthetist
Primary
APN8813
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000804097A
—
GA
05
—
009933518
—
AL
01
—
3074823
BLUE CROSS BLUE SHIELD TN
TN
05
—
3603361
—
TN
01
—
430039249
RAILROAD MEDICARE
TN
05
—
8052090
—
NC
01
—
N346681
WELLCARE (GA MEDICAID)
GA
Enumeration date
12/04/2006
Last updated
03/16/2011
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