Individual
DR. DAVID J KICKLITER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
407 4TH ST, NEWPORT, TN 37821-3755
(423) 623-6240
(423) 623-0102
Mailing address
407 4TH ST, NEWPORT, TN 37821-3755
(423) 623-6240
(423) 623-0102
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
17859
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3028740
—
TN
Enumeration date
12/05/2005
Last updated
11/06/2013
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