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Individual

KEVIN B CHURCHWELL

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
5121 DOCTORS OFC TOWER, 2200 CHILDRENS WAY, NASHVILLE, TN 37232-0001
(731) 660-8759
Mailing address
1804 HIGHWAY 45 BYP, SUITE 604, JACKSON, TN 38305-4436
(731) 660-8759

Taxonomy

Speciality
Code
Description
License number
State
2080P0203X
Pediatric Critical Care Medicine Physician
Primary
26441
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
3068740
BCBS
05
3896512
TN
Enumeration date
09/15/2006
Last updated
07/31/2009
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