Individual
THOMAS E STURDAVANT
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
113 CASSELL DR, KINGSPORT, TN 37660
(423) 246-7240
Mailing address
PO BOX 416, KINGSPORT, TN 37662-0416
(423) 246-7240
Taxonomy
Speciality
Code
Description
License number
State
208100000X
Physical Medicine & Rehabilitation Physician
Primary
16798
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
16798
STATE LICENSE #
MS
Enumeration date
09/27/2006
Last updated
06/26/2018
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