Individual
TENNIS JASPER SUGG JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
DO, MPH
Contact information
Practice address
405 W GRAND AVE, DAYTON, OH 45405-7538
(937) 723-3245
Mailing address
405 W GRAND AVE, DAYTON, OH 45405-7538
(937) 723-3245
Taxonomy
Speciality
Code
Description
License number
State
207P00000X
Emergency Medicine Physician
Primary
5241
KY
390200000X
Student in an Organized Health Care Education/Training Program
—
—
Other
Enumeration date
02/25/2019
Last updated
08/04/2022
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