Individual
DR. W JAN KAZMIER
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2995 FORT HENRY DR, SUITE 100, KINGSPORT, TN 37664-4005
(423) 246-6445
(423) 246-8240
Mailing address
2995 FORT HENRY DR, SUITE 100, KINGSPORT, TN 37664-4005
(423) 246-6445
(423) 246-8240
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MD0000016939
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
006036791
—
VA
01
—
0078009
BLUE CROSS/BLUE SHIELD
TN
01
—
01-41828
UNITED HEALTHCARE
TN
01
—
079672
ANTHEM BCBS
VA
01
—
100010179
PHP TENNESSEE
TN
01
—
110024502
MEDICARE RAILROAD
TN
05
—
3038457
—
TN
01
—
621482794
TAX ID
—
01
—
TN0101
JOHN DEERE HEALTH
TN
Enumeration date
05/03/2006
Last updated
07/18/2013
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