Individual
MICHAEL P KAUZLARICH
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
D.O.
Contact information
Practice address
444 CLINCHFIELD ST STE 2700, KINGSPORT, TN 37660-3858
(423) 230-2700
(423) 239-7402
Mailing address
PO BOX 632476, CINCINNATI, OH 45263-2476
(423) 230-2700
(423) 230-2710
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
1438
TN
207Q00000X
Family Medicine Physician
Primary
1438
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
010312922
—
VA
05
—
1508895
—
TN
01
—
4274358
BLUE CROSS BLUE SHIELD
TN
Enumeration date
12/20/2005
Last updated
02/19/2025
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