Provider Demographics
NPI:1619923729
Name:KEHLER, GEORGE B II (MD)
Entity Type:Individual
Prefix:
First Name:GEORGE
Middle Name:B
Last Name:KEHLER
Suffix:II
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 634706
Mailing Address - Street 2:
Mailing Address - City:CINCINNATI
Mailing Address - State:OH
Mailing Address - Zip Code:45263-0001
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1420 TUSCULUM BLVD
Practice Address - Street 2:
Practice Address - City:GREENEVILLE
Practice Address - State:TN
Practice Address - Zip Code:37745
Practice Address - Country:US
Practice Address - Phone:423-787-5000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-05-26
Last Update Date:2018-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD24072208M00000X, 207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNP00333208OtherRAILROAD MEDICARE
TN3883223Medicaid
TN3883222Medicaid
TN4116087OtherBCBS OF TN
TN4026542OtherBCBS OF TN
TN3883221Medicaid
TN4149920OtherBLUE CROSS
TN4026542OtherBCBS OF TN
TN4116087OtherBCBS OF TN
TN3883222Medicaid
TNP00333208OtherRAILROAD MEDICARE