Provider Demographics
NPI:1114380771
Name:SUMPTER, ZACHARY LINUEL (DO)
Entity Type:Individual
Prefix:DR
First Name:ZACHARY
Middle Name:LINUEL
Last Name:SUMPTER
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:444 CLINCHFIELD ST STE 201
Mailing Address - Street 2:
Mailing Address - City:KINGSPORT
Mailing Address - State:TN
Mailing Address - Zip Code:37660-3863
Mailing Address - Country:US
Mailing Address - Phone:423-230-2700
Mailing Address - Fax:
Practice Address - Street 1:444 CLINCHFIELD ST STE 201
Practice Address - Street 2:
Practice Address - City:KINGSPORT
Practice Address - State:TN
Practice Address - Zip Code:37660-3863
Practice Address - Country:US
Practice Address - Phone:423-230-2700
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-03-31
Last Update Date:2020-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
TN3304207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program