Individual
KEVIN D MISISCHIA
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
444 CLINCHFIELD ST STE 2800, KINGSPORT, TN 37660-3858
(423) 230-2801
(423) 239-7750
Mailing address
PO BOX 632476, CINCINNATI, OH 45263-2476
(423) 230-2801
(423) 239-7750
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
DO1254
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1337280
BLACK LUNG
TN
01
—
209176
UMWA
TN
05
—
3305853
—
TN
01
—
384392
BLUE CROSS BLUE SHIELD
VA
01
—
4022997
BLUE CROSS BLUE SHIELD
TN
05
—
5607299
—
VA
01
—
62158439133
JOHN DEERE
TN
01
—
CA4007
MEDICARE RAILROAD
TN
Enumeration date
05/11/2006
Last updated
02/20/2025
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