Individual
MR. ITTAMVEETIL NARAYANAN KUTTY
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2463 WILDWOOD DR, STE 12, KINGSPORT, TN 37660-5800
(423) 288-7869
(423) 392-6511
Mailing address
1167 SPRATLIN PARK DRIVE, FRONTIER HEALTH, GRAY, TN 37615
(423) 467-3658
(423) 467-3644
Taxonomy
Speciality
Code
Description
License number
State
2084P0800X
Psychiatry Physician
Primary
MD0000016494
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0048066
BCBS
TN
01
—
069097
BCBS
VA
05
—
3016081
—
TN
Enumeration date
07/13/2006
Last updated
06/01/2012
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