Individual
DR. THOMAS J CARUTHERS JR.
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
629 NUCKOLLS RD, BOLIVAR, TN 38008-1599
(731) 658-3388
(731) 658-1719
Mailing address
97 EMILY CV, ATOKA, TN 38004-7475
(901) 463-0072
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
TN0000029623
TN
207V00000X
Obstetrics & Gynecology Physician
Primary
TN000029623
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
1730138355
NPI
—
05
—
3810696
—
TN
Enumeration date
05/09/2006
Last updated
04/26/2018
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