Basic Information
Provider Information
NPI: 1710935341
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: TOYNE
FirstName: SUSANNE
MiddleName:  
NamePrefix: DR.
NameSuffix:  
Credential: MD
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1 CORNER OF LAMONT AND SIDNEY ST
Address2:  
City: MOUNTAIN HOME
State: TN
PostalCode: 37681
CountryCode: US
TelephoneNumber: 4239261171
FaxNumber: 4239793685
Practice Location
Address1: CORNER OF SIDNEY AND LAMONT
Address2:  
City: MOUNTAIN HOME
State: TN
PostalCode: 376844000
CountryCode: US
TelephoneNumber: 4239261171
FaxNumber: 4239793685
Other Information
ProviderEnumerationDate: 05/05/2006
LastUpdateDate: 10/05/2009
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207Q00000X18426TNY Allopathic & Osteopathic PhysiciansFamily Medicine 

No ID Information.


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