Individual
LISA S KELLOGG
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
1531 HUNT CLUB BLVD STE 100, GALLATIN, TN 37066-6096
(615) 431-9930
(615) 431-9940
Mailing address
3024 BUSINESS PARK CIR, GOODLETTSVILLE, TN 37072-3132
(615) 239-2018
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
1755
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
33000031
MEDICARE TAX ID 201119913
TN
05
—
33000032
—
TN
01
—
P00419528
RAILROAD MEDICARE
—
Enumeration date
05/26/2006
Last updated
11/07/2025
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