Provider Demographics
NPI:1346336385
Name:NETHERTON, CYNTHIA L (MD)
Entity Type:Individual
Prefix:
First Name:CYNTHIA
Middle Name:L
Last Name:NETHERTON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4155 CAROTHERS PKWY
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:TN
Mailing Address - Zip Code:37067-5905
Mailing Address - Country:US
Mailing Address - Phone:615-794-8800
Mailing Address - Fax:615-791-4440
Practice Address - Street 1:4155 CAROTHERS PKWY
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:TN
Practice Address - Zip Code:37067-5905
Practice Address - Country:US
Practice Address - Phone:615-794-8800
Practice Address - Fax:615-791-4440
Is Sole Proprietor?:No
Enumeration Date:2006-10-05
Last Update Date:2012-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN013296174400000X
TNMD13296207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
3009885Medicare ID - Type Unspecified
A97417Medicare UPIN