Kesterson, Gregg H.D.

Kesterson, Gregg H.D. is an sole proprietor health care provider with primary practice located at 105 Broyles Dr Suite B, Johnson City TN 37601-2542. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Internal Medicine, Allopathic & Osteopathic Physicians / Addiction Medicine. Allopathic & Osteopathic Physicians / Addiction Medicine is his primary health care specialty. Kesterson, Gregg H.D. can be contacted via phone (423) 722-4000.

Contact Information

Primary practice address
105 Broyles Dr Suite B Johnson City TN 37601-2542
Phone: (423) 722-4000
Fax: (423) 722-4004
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Internal Medicine 207R00000X 17126 Tennessee
Allopathic & Osteopathic Physicians / Addiction Medicine 207RA0401X 17126 Tennessee

Profile Details

NPI number 1376585919
LBN Legal business name Kesterson, Gregg H.D.
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jun 11th, 2006
Last updated Nov 19th, 2016 - about 10 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1376585919 NPPES
Tennessee Other 110098564 RR MEDICARE PIN
Tennessee MEDICAID 3019399 RR MEDICARE PIN

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