Individual
DR. CATHLEEN CONNIE SUTO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
550 SUNSET TRL, JELLICO, TN 37762-2343
(423) 784-5771
(423) 784-6185
Mailing address
107 S MAIN ST, P.O. BOX 540, JELLICO, TN 37762-2154
(423) 784-8492
(423) 784-8358
Taxonomy
Speciality
Code
Description
License number
State
207V00000X
Obstetrics & Gynecology Physician
41746
KY
207V00000X
Obstetrics & Gynecology Physician
Primary
43450
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0297024
KY MEDICARE
KY
01
—
41746
STATE LICENSE
KY
01
—
43450
STATE LICENSE
TN
05
—
7100065240
—
KY
Enumeration date
09/12/2005
Last updated
03/07/2023
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