Individual
MR. JONATHAN M KERLEY
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
2372 LIFESTYLE WAY STE 152, CHATTANOOGA, TN 37421-4940
(423) 894-0432
(423) 894-0475
Mailing address
7000 LEE HWY, SUITE 600, CHATTANOOGA, TN 37421-1799
(423) 894-0432
(423) 894-0475
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
2007029189
MO
207R00000X
Internal Medicine Physician
Primary
1427
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
3307024
MEDICARE PTAN
TN
05
—
3307024
—
TN
01
—
3307028
MEDICARE PTAN
TN
01
—
3370172
MEDICARE PTAN
TN
01
—
3726561
MEDICARE PTAN
TN
Enumeration date
01/17/2006
Last updated
09/27/2020
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