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Individual

KENNETH R LISTER

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
49 CLEVELAND ST STE 230, CROSSVILLE, TN 38555-2854
(931) 210-5701
(931) 210-5702
Mailing address
49 CLEVELAND ST STE 230, CROSSVILLE, TN 38555-2854
(931) 210-5701
(931) 210-5702

Taxonomy

Speciality
Code
Description
License number
State
207LP2900X
Pain Medicine (Anesthesiology) Physician
Primary
MD8024
TN

Other

Enumeration date
07/12/2005
Last updated
09/06/2023
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