Provider Demographics
NPI:1528717360
Name:SHETH, KEVIN P (DO)
Entity type:Individual
Prefix:DR
First Name:KEVIN
Middle Name:P
Last Name:SHETH
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:152 KALEY LN
Mailing Address - Street 2:
Mailing Address - City:LENOIR CITY
Mailing Address - State:TN
Mailing Address - Zip Code:37771-2074
Mailing Address - Country:US
Mailing Address - Phone:423-404-0087
Mailing Address - Fax:
Practice Address - Street 1:152 KALEY LN
Practice Address - Street 2:
Practice Address - City:LENOIR CITY
Practice Address - State:TN
Practice Address - Zip Code:37771-2074
Practice Address - Country:US
Practice Address - Phone:423-404-0087
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-21
Last Update Date:2025-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MB12622600207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine