Individual
MR. KEVIN MAURICE DANSBY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
1060 PEERLESS XING NW, CLEVELAND, TN 37312-3784
(423) 479-4165
Mailing address
7100 COMMERCE WAY, SUITE 180, BRENTWOOD, TN 37027-2829
(615) 465-7000
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
PA0000001138
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
4092111
BCBS
TN
Enumeration date
06/17/2005
Last updated
08/18/2009
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