The Sutherland Clinic LLC
Organization Active NPI Family Medicine Physician · Paris, MO
NPI 1992800635 · NPPES record last updated Jan 5, 2009
Key facts
- NPI
- 1992800635
- Entity type
- Organization (NPI type 2)
- Primary specialty
- Family Medicine Physician 207Q00000X
- License
- 113731 (MO)
- Legal business name
- THE SUTHERLAND CLINIC LLC
- Practice address
- 221 N Main St
Paris, MO 65275-1328 - Phone
- (660) 327-6416
- Fax
- (660) 327-6217
- NPI assigned
- Sep 14, 2006
- Organization subpart
- No
Authorized official
- Name
- Dr. Charles Sutherland, DO
- Title
- Owner
- Phone
- (660) 327-6407
Practitioners 1
-
Cody W. Davis, DO
National Provider Directory
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Family Medicine Physician |
207Q00000X | 113731 | MO | Yes |
Addresses
Primary practice location
221 N Main St
Paris, MO 65275-1328
Mailing address
221 N Main St
PO Box 206
Paris, MO 65275-1328
Phone (660) 327-6416
Other identifiers
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 245101407 | Medicaid | MO |
Other providers in Paris, MO
- Senior Citizens Community Center
- Senior Citizens Community Center
- Deborah Colleen Shouse
- SSM Audrain Health Care, Inc.
- Julie Surdal
- Aggrey Wanyonyi
- Katelin Moore Worthington
- Elizabeth Black Wyant
All providers in Paris, MO · Family Medicine Physician in Missouri
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 5, 2009. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.