Individual
SUBANITHYA DHAMOTHARAN
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
M.D.
Contact information
Practice address
3170 APPALACHIAN HWY, SUITE 5, JACKSBORO, TN 37757-5500
(423) 907-1700
(423) 907-1711
Mailing address
3170 APPALACHIAN HWY, SUITE 5, JACKSBORO, TN 37757-5500
(423) 907-1700
(423) 907-1711
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
TN51774
TN
Other
Enumeration date
07/23/2011
Last updated
08/22/2014
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