Provider Demographics
NPI:1851306732
Name:KEHLER, KARL BRADLEY (OD)
Entity Type:Individual
Prefix:DR
First Name:KARL
Middle Name:BRADLEY
Last Name:KEHLER
Suffix:
Gender:M
Credentials:OD
Other - Prefix:DR
Other - First Name:K BRADLEY
Other - Middle Name:
Other - Last Name:KEHLER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:OD
Mailing Address - Street 1:2311 PIERCE AVE
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37232-8808
Mailing Address - Country:US
Mailing Address - Phone:615-936-2020
Mailing Address - Fax:
Practice Address - Street 1:2311 PIERCE AVE
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37232-8808
Practice Address - Country:US
Practice Address - Phone:615-936-2020
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-30
Last Update Date:2012-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN2370152W00000X, 152WC0802X, 152WL0500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
No152WC0802XEye and Vision Services ProvidersOptometristCorneal and Contact Management
No152WL0500XEye and Vision Services ProvidersOptometristLow Vision Rehabilitation
Provider Identifiers
StateIdentifier IDID TypeIssuer
U92087Medicare UPIN