Individual
DR. KEVIN SCOTT CORNWELL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
111 W STONE DR STE 100, KINGSPORT, TN 37660-6027
(423) 247-5197
(423) 247-5254
Mailing address
1021 W OAKLAND AVE STE 310, JOHNSON CITY, TN 37604-2192
(423) 302-6565
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
MD40735
TN
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
2020-00015
NC
207RC0200X
Critical Care Medicine (Internal Medicine) Physician
40735
TN
207RP1001X
Pulmonary Disease Physician
2020-00015
NC
207RP1001X
Pulmonary Disease Physician
Primary
40735
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
P00855262
MEDICARE RR
TN
Enumeration date
07/04/2006
Last updated
02/29/2024
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