Individual
DR. KENNETH LEE JUSTICE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1130 MIDDLE CREEK RD STE 260, SEVIERVILLE, TN 37862-3055
(865) 428-7586
(865) 428-8671
Mailing address
PO BOX 440061, NASHVILLE, TN 37244-0061
(865) 670-6199
(865) 670-6198
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
30763
TN
207Q00000X
Family Medicine Physician
MD0000030763
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3831218
—
TN
05
—
3831219
—
TN
Enumeration date
05/17/2006
Last updated
10/30/2023
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