Individual
DOUGLAS W KANE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
315 N WASHINGTON AVE, STE 230, COOKEVILLE, TN 38501-2660
(931) 520-8457
(931) 520-6373
Mailing address
315 N WASHINGTON AVE, STE 230, COOKEVILLE, TN 38501-2660
(931) 520-8457
(931) 520-6373
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
18467
TN
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
18467
TN
207RP1001X
Pulmonary Disease Physician
Primary
18467
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
010695688
TAX ID
—
01
—
020404400
US DEPT OF LABOR
—
01
—
204044
BLACK LUNG
—
01
—
290015314
RAILROAD MEDICARE PIN
TN
01
—
3374966
MEDICARE GROUP PIN
TN
05
—
3374966
—
TN
05
—
3858249
—
TN
01
—
4026322
BLUE CROSS PIN
TN
05
—
64049687
—
KY
01
—
7641262
CIGNA
—
Enumeration date
07/11/2006
Last updated
02/28/2012
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