Provider Demographics
NPI:1023077534
Name:SAKBUN, RATHEANY (MD)
Entity type:Individual
Prefix:DR
First Name:RATHEANY
Middle Name:
Last Name:SAKBUN
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 1:7557B DANNAHER DR
Mailing Address - Street 2:SUITE G55
Mailing Address - City:POWELL
Mailing Address - State:TN
Mailing Address - Zip Code:37849-3568
Mailing Address - Country:US
Mailing Address - Phone:865-859-7370
Mailing Address - Fax:865-859-7389
Practice Address - Street 1:7557B DANNAHER DR
Practice Address - Street 2:SUITE G55
Practice Address - City:POWELL
Practice Address - State:TN
Practice Address - Zip Code:37849-3568
Practice Address - Country:US
Practice Address - Phone:865-859-7370
Practice Address - Fax:865-859-7389
Is Sole Proprietor?:No
Enumeration Date:2006-03-22
Last Update Date:2016-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD52312207VG0400X, 207VG0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207VG0400XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNQ012154Medicaid
TNQ012154Medicaid
TN103I161272Medicare PIN
G65343Medicare UPIN