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General NPI Number Information
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NPI Number | 1548524390
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Entity Type | Individual
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Provider Name | STRUDWICK LOUIS TUTWILER DMD, MS
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Gender | Male
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Dates
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Enumeration Date | 06/26/2012
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Last Update Date | 08/22/2019
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Provider Practice Location Address
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Address Line | 2729 W ANDREW JOHNSON HWY
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City | MORRISTOWN
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State | TN
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Zip | 37814-3215
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Country | US
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Telephone | 423-621-2000
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Fax | 423-621-2001
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Provider Business Mailing Address
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Address Line | PO BOX 532
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City | MORRISTOWN
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State | TN
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Zip | 37815
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Country | US
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Telephone | 423-621-2000
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Fax | 423-621-2001
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1223E0200X
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Taxonomy Name | Endodontics
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License Number | DS0000010916
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License Number State | TN
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