Individual
DR. JONATHAN SPENCER SUTHER
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
130 W RAVINE RD, KINGSPORT, TN 37660-3837
(423) 968-1144
Mailing address
3053 W STATE ST, BRISTOL, TN 37620-1720
(423) 968-1144
Taxonomy
Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
35920
AL
2085R0202X
Diagnostic Radiology Physician
Primary
57510
TN
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
Q044685
—
TN
Enumeration date
03/21/2012
Last updated
11/14/2018
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