Individual
DR. PAUL W SUTHERLAND
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
800 E LOCUST ST, OLNEY, IL 62450-2553
(618) 395-7340
Mailing address
PO BOX 97, OLNEY, IL 62450-0097
(618) 395-7340
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
036-060342
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
0360603421
—
IL
Enumeration date
11/16/2005
Last updated
10/28/2011
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