Individual
DR. KELLY S OGGERO
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
130 W RAVINE RD STE 3A, KINGSPORT, TN 37660-3841
(423) 245-6101
Mailing address
1021 W OAKLAND AVE STE 310, JOHNSON CITY, TN 37604-2192
(423) 302-6565
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
50412
TN
208600000X
Surgery Physician
H0700
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
P000G86F4
—
TX
Enumeration date
06/14/2006
Last updated
10/09/2023
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