Individual
KENNETH E. CUTSHALL
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
2 PROFESSIONAL PARK DR STE 11, JOHNSON CITY, TN 37604-6584
(423) 975-5650
(423) 975-5652
Mailing address
PO BOX 52948, KNOXVILLE, TN 37950-2948
(865) 306-5700
(865) 584-7760
Taxonomy
Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
MD19352
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
3001652350001
—
VA
05
—
Q009403
—
TN
Enumeration date
09/23/2005
Last updated
07/27/2022
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