Provider Demographics
NPI:1023055563
Name:SLEETER, DONALD RAY (MD)
Entity type:Individual
Prefix:DR
First Name:DONALD
Middle Name:RAY
Last Name:SLEETER
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2348 W ANDREW JOHNSON HWY STE 186
Mailing Address - Street 2:
Mailing Address - City:MORRISTOWN
Mailing Address - State:TN
Mailing Address - Zip Code:37814-3208
Mailing Address - Country:US
Mailing Address - Phone:423-437-3133
Mailing Address - Fax:
Practice Address - Street 1:110 HOSPITAL DR
Practice Address - Street 2:
Practice Address - City:JEFFERSON CITY
Practice Address - State:TN
Practice Address - Zip Code:37760-5282
Practice Address - Country:US
Practice Address - Phone:865-471-2500
Practice Address - Fax:865-471-2450
Is Sole Proprietor?:No
Enumeration Date:2006-06-01
Last Update Date:2024-02-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN375882083A0300X, 207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No2083A0300XAllopathic & Osteopathic PhysiciansPreventive MedicineAddiction Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3888428Medicaid
TNP00282925OtherRAILROAD MEDICARE
TN4068270OtherBC BS
TN3888428Medicare PIN
TN3888428Medicaid