Michael Dillon Sutherland, PHARM.D.
Individual provider Active NPI Pharmacist · McCarr, KY
NPI 1992820823 · NPPES record last updated Jun 12, 2014
Key facts
- NPI
- 1992820823
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Pharmacist 183500000X
- License
- 016414 (KY)
- Practice address
- 11349 State Highway 1056
McCarr, KY 41544 - Phone
- (606) 427-9007
- Fax
- (606) 427-9184
- NPI assigned
- Mar 20, 2007
- Sex
- Male
- Sole proprietor
- No
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- Yes
- Credentials
- Doctor of Pharmacy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 016414 | KY | MD | Pharmacist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Wise Chiropractic | Past | Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Pharmacist | 183500000X | 016414 | KY | Yes |
Addresses
Primary practice location
11349 State Highway 1056
McCarr, KY 41544
Mailing address
216 Park Ave NE
Wise, VA 24293-5110
Phone (276) 328-2782
Other providers in McCarr, KY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jun 12, 2014. 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.