Individual
DR. KELLY D CHUMBLEY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO
Contact information
Practice address
130 W RAVINE RD, KINGSPORT, TN 37660-3837
(423) 224-5109
(423) 224-5120
Mailing address
4750 HEMPSTEAD STATION DR, KETTERING, OH 45429-5164
(800) 875-0136
(937) 619-4342
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
0102202993
VA
207P00000X
Emergency Medicine Physician
34008110
OH
207P00000X
Emergency Medicine Physician
DO1771
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3319837
—
TN
05
—
3319838
—
TN
Enumeration date
05/18/2006
Last updated
01/28/2022
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