Individual
DR. LARRY R KILLEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2370 N OCOEE ST, CLEVELAND, TN 37311-3850
(423) 479-6214
(423) 614-4405
Mailing address
PO BOX 3990, CLEVELAND, TN 37320-3990
(423) 479-6214
(423) 614-4405
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
020528
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3051907
—
TN
Enumeration date
07/07/2005
Last updated
10/13/2010
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