MEDICARE: V SUTTON HEALTHCARE LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician

General Provider Information

NPI Number	:	1467127274
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	V SUTTON HEALTHCARE LLC

Provider Business Mailing Address
First Line	:	903 NATIVE RYE WAY
Second Line	:
City	:	LEXINGTON
State	:	SC
Zip	:	29073-6206
Country	:	US
Telephone Number	:	803-429-0300
Fax Number	:

Provider Business Practice Location Address
First Line	:	903 NATIVE RYE WAY
Second Line	:
City	:	LEXINGTON
State	:	SC
Zip	:	29073-6206
Country	:	US
Telephone Number	:	803-429-0300
Fax Number	:

Authorized Official
Title or Position	:	OWNER/NURSE PRACTITIONER
Name	:	VALEEA SUTTON
Credential	:	NP
Telephone Number	:	803-429-0300

Provider Enumeration Date	:	08/13/2021
Last Update Date	:	08/13/2021

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