Doctor Name: | NEAL KENT SUTHERS |
NPI Number: | 1700885894 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | MD |
License Number: | 9573 |
Business Practice Address: | 1001 Hwy 64 N Buffalo, OK - 738340010 |
Business Phone Number: | 5807352506 |
Business Fax Number: | 5807352728 |
Mailing Address: | Po Box 10, BUFFALO |
State: | OK |
Postal Code: | 738340010 |
Phone Number: | 5807352506 |
Fax Number: | 5807352728 |
NPI Enumeration Date: | 07/20/2005 |
NPI Last Update Date: | 09/21/2012 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | 9573 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | OK |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |