Organization
THE SUTHERLAND CLINIC LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. CHARLES SUTHERLAND DO (OWNER)
(660) 327-6407
Entity
Organization
Contact information
Practice address
221 N MAIN ST, PARIS, MO 65275-1328
(660) 327-6416
(660) 327-6217
Mailing address
221 N MAIN ST, PO BOX 206, PARIS, MO 65275-1328
(660) 327-6416
(660) 327-6217
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
113731
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
245101407
—
MO
Enumeration date
09/14/2006
Last updated
01/05/2009
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