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Individual

RICHARD T. KUBOTA

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
MD

Contact information

Practice address
130 W RAVINE RD, KINGSPORT, TN 37660
(423) 968-1144
Mailing address
3053 W STATE ST, BRISTOL, TN 37620-1720

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
0101035580
VA
2085R0202X
Diagnostic Radiology Physician
Primary
31154
TN

Other

Enumeration date
11/07/2006
Last updated
08/21/2024
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