Individual
KELLY MOORE SUTHERLAND
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
DO
Contact information
Practice address
3581 HARRODSBURG RD STE 350, LEXINGTON, KY 40513-1140
(859) 313-6333
(859) 313-3484
Mailing address
PO BOX 936, LONDON, KY 40743-0936
(606) 330-7835
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
04849
KY
2084P0800X
Psychiatry Physician
R4811
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100616800
—
KY
Enumeration date
03/27/2018
Last updated
02/20/2025
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