Individual
BENJAMIN EDWARD KELLOGG
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
301 WHITE OAK RD, DAYTON, TN 37321-2530
(423) 267-0466
Mailing address
979 E 3RD ST, SUITE 300, CHATTANOOGA, TN 37403-2136
(423) 267-0466
(423) 757-0770
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
MD49567
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003135914A
—
GA
01
—
42353870
BCBS
TN
01
—
P01276014
RR MEDICARE
—
05
—
Q002629
—
TN
Enumeration date
08/15/2008
Last updated
09/20/2019
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