# THOMAS STURDAVANT MD PA

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1952896508
- **Authorized official:** THOMAS STURDAVANT MD (OWNER)
- **Authorized official phone:** (228) 860-4448

## Contact information

- **Practice address:** 113 CASSELL DR, KINGSPORT, TN 37660-3775
- **Practice address phone:** (423) 246-7240
- **Mailing address:** PO BOX 416, KINGSPORT, TN 37662-0416
- **Mailing address phone:** (423) 246-7240

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 208100000X | Physical Medicine & Rehabilitation Physician | — | NULL | Yes |
| 208100000X | Physical Medicine & Rehabilitation Physician | — | — | Yes |

## Other

- **Enumeration date:** 06/26/2018
- **Last updated:** 06/26/2018