Individual
KENNETH E. OLIVE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
325 N STATE OF FRANKLIN RD FL 2, JOHNSON CITY, TN 37604-6092
(423) 439-7280
(423) 439-8110
Mailing address
PO BOX 699, MOUNTAIN HOME, TN 37684-0699
(423) 439-7280
(423) 439-8110
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
MD19625
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
Q009841
—
TN
Enumeration date
09/16/2005
Last updated
01/24/2024
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