Provider Demographics
NPI:1851586176
Name:RUTLAND, KATHRYN T (MD)
Entity Type:Individual
Prefix:DR
First Name:KATHRYN
Middle Name:T
Last Name:RUTLAND
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 1:430 NORTHCREST DRIVE
Mailing Address - Street 2:
Mailing Address - City:SPRINGFIELD
Mailing Address - State:TN
Mailing Address - Zip Code:37172-0000
Mailing Address - Country:US
Mailing Address - Phone:615-382-7284
Mailing Address - Fax:615-382-8231
Practice Address - Street 1:430 NORTHCREST DRIVE
Practice Address - Street 2:
Practice Address - City:SPRINGFIELD
Practice Address - State:TN
Practice Address - Zip Code:37172-0000
Practice Address - Country:US
Practice Address - Phone:615-382-7284
Practice Address - Fax:615-382-8231
Is Sole Proprietor?:No
Enumeration Date:2007-09-10
Last Update Date:2011-01-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN46612207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine