Provider Demographics
NPI:1326835141
Name:NETHERCUTT, DOLAN AUSTIN
Entity type:Individual
Prefix:MR
First Name:DOLAN
Middle Name:AUSTIN
Last Name:NETHERCUTT
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1200 PARK RD
Mailing Address - Street 2:
Mailing Address - City:HARRISONBURG
Mailing Address - State:VA
Mailing Address - Zip Code:22802-2404
Mailing Address - Country:US
Mailing Address - Phone:571-485-0385
Mailing Address - Fax:
Practice Address - Street 1:1200 PARK RD
Practice Address - Street 2:
Practice Address - City:HARRISONBURG
Practice Address - State:VA
Practice Address - Zip Code:22802-2404
Practice Address - Country:US
Practice Address - Phone:703-679-7396
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-04-23
Last Update Date:2025-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program