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Individual

DR. GERALD F LONDON

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD FACP

Contact information

Practice address
135 W RAVINE RD, SUITE 3A, KINGSPORT, TN 37660-3847
(423) 246-6777
(423) 246-7766
Mailing address
135 W RAVINE RD, SUITE 3A, KINGSPORT, TN 37660-3847
(423) 246-6777
(423) 246-7766

Taxonomy

Speciality
Code
Description
License number
State
207RG0100X
Gastroenterology Physician
Primary
MD020536
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
000000053386
ANTHEM
KY
01
000135151
BCBS OF TN
TN
05
006037020
VA
01
058719
ANTHEM
VA
01
100010622
PHP TENNCARE
TN
05
1830464000
WV
05
3700033
TN
01
4675259
AETNA
TN
05
64922735
KY
01
TN0104
UNITED HEALTHCARE RIVER V
TN
Enumeration date
09/14/2005
Last updated
05/27/2008
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