DR. VIKTOR P SULKOWSKI (NPI# 1780796003) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1780796003 |
| Entity Type | Individual |
| Full Name | DR. VIKTOR P SULKOWSKI |
| Credential | M.D. |
| Practice Address |
10461 Wallace Alley St Kingsport TN 37663-3936 |
| Mailing Address |
3101 Browns Mill Rd Ste 6 Pmb 386 Johnson City TN 37604-4100 |
| Practice Telephone | 4232791400 |
| Mailing Telephone | 4238540001 |
| Mailing Fax Number | 4238540002 |
| Enumeration Date | 2006-08-31 |
| Last Update Date | 2007-07-09 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 174400000X | Specialist | MD0000010318 | TN | Other Service Providers |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| TN | BCBS TN PROVIDER NUMBER | 4051152 | 01 |
| TN | 3379190 | 05 | |
| TN | BCBS TN GRP PROVIDER NUMB | 4051167 | 01 |
| Street Address |
10461 WALLACE ALLEY ST |
| City | KINGSPORT |
| State | TN |
| Zip Code | 37663-3936 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1700887106 | Jeffrey P Fenyves | Internal Medicine | 10461 Wallace Alley St, Kingsport, TN 37663-3936 | 2005-08-09 |
| 1811431406 | Genesia Dickson Irick | Nurse Practitioner | 10461 Wallace Alley St, Kingsport, TN 37663-3936 | 2016-12-15 |
| 1972777845 | Ahp of East Tennessee Pllc | Nurse Anesthetist, Certified Registered | 10461 Wallace Alley St, Kingsport, TN 37663-3936 | 2008-04-22 |
| 1487870077 | Ashley Laine Anderson | Nurse Practitioner | 10461 Wallace Alley St, Kingsport, TN 37663-3936 | 2007-04-18 |
| 1669584991 | East Tennessee Anesthesia Providers, PC | Specialist | 10461 Wallace Alley St, Kingsport, TN 37663-3936 | 2006-08-31 |
| 1083639918 | Tri-cities Gastroenterology LLC | Internal Medicine | 10461 Wallace Alley St, Kingsport, TN 37663-3936 | 2006-07-13 |
| 1063437994 | Tri-cities Endoscopy Center PC | Clinic/Center | 10461 Wallace Alley St, Kingsport, TN 37663-3936 | 2006-07-13 |
| 1750382982 | Stephen W Fry | Internal Medicine | 10461 Wallace Alley St, Kingsport, TN 37663-3936 | 2005-08-10 |
| 1497756787 | Susanne S Mckinney | Registered Nurse | 10461 Wallace Alley St, Kingsport, TN 37663-3936 | 2005-08-09 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1649528126 | Northland Hearing Centers, Inc. | Hearing Instrument Specialist | 1567 North Eastman Road, Kingsport, TN 37663 | 2012-08-15 |
| 1548546419 | Vickie R Harris | Counselor | 317 Pitt Road, Kingsport, TN 37663 | 2011-10-24 |
| 1467746446 | Eric A. Echard | Dentist | 1339 Moreland Drive, Suite 1, Kingsport, TN 37663 | 2011-06-07 |
| 1619003399 | Colonial Heights Pharmacy, Inc. | Pharmacy | 4221 Ft. Henry Drive, Kingsport, TN 37663 | 2007-02-26 |
| 1316005986 | Robert F Mcamis Jr. | Dentist | 4016 Fort Henry Drive, Kingsport, TN 37663 | 2006-12-05 |
| 1467567412 | Colonial Heights Dental Assocaites | Dentist | 150 Clinic Drive, Suite A, Kingsport, TN 37663 | 2006-08-20 |
| 1194777953 | Nicholas Brett Smith | Family Medicine | 4600 Fort Henry Dr, Kingsport, TN 37663 | 2006-05-17 |
| 1396720108 | Resp-i-care, Inc. | Durable Medical Equipment & Medical Supplies | 648 Eastern Star Rd, Kingsport, TN 37663 | 2005-12-14 |
| 1023000429 | Darryl Fontaine | Anesthesiology | 4105 Fort Henry Drive, Suite 207, Kingsport, TN 37663 | 2005-08-22 |
| 1659701696 | Jordan Burke | Physician Assistant | 4600 Fort Henry Dr, Kingsport, TN 37663 | 2013-11-12 |
| Find all providers in zip 37663 | ||||
| Taxonomy Code | 174400000X |
| Grouping | Other Service Providers |
| Classification | Specialist |
| An individual educated and trained in an applied knowledge discipline used in the performance of work at a level requiring knowledge and skills beyond or apart from that provided by a general education or liberal arts degree. |
| Notes: Source: Expanded from Webster’s II New Riverside University Dictionary, Boston: Riverside Publishing Company, 1974. |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1508391012 | Chelsey Bishop | Specialist | 400 Blue Haven Dr, Kingsport, TN 37663-3043 | 2017-04-23 |
| 1326397910 | Simpson Clinic, LLC | Specialist | 2012 Brookside Drive, Suite 8, Kingsport, TN 37660 | 2012-08-29 |
| 1639343734 | K. G. Porter, Md, LLC | Specialist | 1936 Brookside Dr Ste C, Kingsport, TN 37660-4654 | 2008-04-18 |
| 1760593834 | Premier Anesthesia Services PC | Specialist | 2000 Brookside Drive, Suite 207, Kingsport, TN 37660-4627 | 2006-08-31 |
| 1043228646 | Randall J Falconer Md PC | Specialist | 1728 N Eastman Road, Kingsport, TN 37664 | 2006-08-03 |
| 1235197815 | W Jan Kazmier | Specialist | 2995 Fort Henry Dr, Suite 100, Kingsport, TN 37664-4005 | 2006-05-03 |
| 1649641200 | Sam W. Huddleston Iv Md PC | Specialist | 2002 Brookside Dr, Suite# 201, Kingsport, TN 37660-4634 | 2015-10-08 |
| 1346686763 | Blue Ridge Medical Management Corporation | Specialist | 2002 Brookside Dr, Suite 300a, Kingsport, TN 37660-4634 | 2013-05-13 |
| 1730395153 | Donna Howard Crotts | Specialist | 130 W Ravine Rd, Kingsport, TN 37660-3810 | 2007-05-15 |
| 1932312337 | Heather Christine Wallen | Specialist | 1041 East Sullivan Street, Kingsport, TN 37660 | 2007-05-08 |
| Find all providers in KINGSPORT | ||||
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.