Individual
MARK EDWARD SUTHERLAND
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
2717 SUMMERHILL RD, TEXARKANA, TX 75503-3957
(903) 792-3773
(903) 792-1291
Mailing address
2717 SUMMERHILL RD, TEXARKANA, TX 75503-3957
(903) 792-3773
(903) 792-1291
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
J7221
TX
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
125618001
—
AR
05
—
159065501
—
TX
Enumeration date
06/05/2006
Last updated
01/26/2012
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