Sutherland, Mark Edward

Sutherland, Mark Edward is an sole proprietor health care provider with primary practice located at 2717 Summerhill Rd , Texarkana TX 75503-3957. He recently has only one registered license in Allopathic & Osteopathic Physicians / Surgery, which is considered as his primary health care specialty. Sutherland, Mark Edward can be contacted via phone (903) 792-3773.

Contact Information

Primary practice address
2717 Summerhill Rd Texarkana TX 75503-3957
Phone: (903) 792-3773
Fax: (903) 792-1291
Website:
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Health care specialties

SpecialtyCodeLicense #State
Allopathic & Osteopathic Physicians / Surgery 208600000X J7221 Texas

Profile Details

NPI number 1023057353
LBN Legal business name Sutherland, Mark Edward
Credentials Doctor of Medicine (MD)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jun 5th, 2006
Last updated Jan 26th, 2012 - about 13 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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Identifiers

StateTypeNumberIssuer
All States NPI 1023057353 NPPES
Texas MEDICAID 159065501
Texas MEDICAID 125618001

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