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Individual

DR. TERRY ROBERT KETCH

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
3443 DICKERSON PIKE STE 430, NASHVILLE, TN 37207-2524
(615) 868-0352
(615) 868-4076
Mailing address
3443 DICKERSON PIKE STE 430, NASHVILLE, TN 37207-2524
(615) 868-0352

Taxonomy

Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
2006-01296
NC
207RC0000X
Cardiovascular Disease Physician
Primary
31153
TN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
1514207
TN
05
3041819
TN
01
4232884
BCBS-TN
TN
05
7100092060
KY
01
P00727334
RR MEDICARE
TN
Enumeration date
01/25/2007
Last updated
01/13/2022
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