Provider Demographics
NPI:1659068948
Name:STURGILL, GARY K (PHD)
Entity Type:Individual
Prefix:DR
First Name:GARY
Middle Name:K
Last Name:STURGILL
Suffix:
Gender:M
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1320 AUTUMN SPRINGS LN
Mailing Address - Street 2:
Mailing Address - City:OLD HICKORY
Mailing Address - State:TN
Mailing Address - Zip Code:37138-2365
Mailing Address - Country:US
Mailing Address - Phone:615-260-1504
Mailing Address - Fax:
Practice Address - Street 1:1320 AUTUMN SPRINGS LN
Practice Address - Street 2:
Practice Address - City:OLD HICKORY
Practice Address - State:TN
Practice Address - Zip Code:37138-2365
Practice Address - Country:US
Practice Address - Phone:615-260-1504
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-04-18
Last Update Date:2023-04-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN0449101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health