Provider Demographics
NPI:1851574578
Name:KENT KYGER MD PC
Entity Type:Organization
Organization Name:KENT KYGER MD PC
Other - Org Name:KENT KYGER MD PC
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PSYCHIATRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:KENT
Authorized Official - Middle Name:
Authorized Official - Last Name:KYGER
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:615-383-4694
Mailing Address - Street 1:2011 ASHWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37212-5015
Mailing Address - Country:US
Mailing Address - Phone:615-383-4694
Mailing Address - Fax:615-383-0228
Practice Address - Street 1:2011 ASHWOOD AVE
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37212-5015
Practice Address - Country:US
Practice Address - Phone:615-383-4694
Practice Address - Fax:615-383-0228
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-17
Last Update Date:2007-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD38202084P0804X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes2084P0804XAllopathic & Osteopathic PhysiciansPsychiatry & NeurologyChild & Adolescent PsychiatryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN2000428OtherBCBS
TN3105979Medicaid
TN3105979Medicare PIN
TN2000428OtherBCBS