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NPI Code Detail

MEDICARE: MR. MARK ALLEN SUTTON ABO,NCLE,LDO

MEDICARE: MR. MARK ALLEN SUTTON ABO,NCLE,LDO
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
1156FX1800XOptician307115KY

General Provider Information

NPI Number : 1609723725
Entity Type Code : Individual
Provider Name (Legal Business Name) : MR. MARK ALLEN SUTTON ABO,NCLE,LDO
Provider Business Mailing Address
First Line : 1195 BARRET BLVD
Second Line :
City : HENDERSON
State : KY
Zip : 42420-7508
Country : US
Telephone Number : 270-826-6036
Fax Number : 270-831-8676
Provider Business Practice Location Address
First Line : 1195 BARRET BLVD
Second Line :
City : HENDERSON
State : KY
Zip : 42420-7508
Country : US
Telephone Number : 270-831-8686
Fax Number : 270-831-8676
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 03/16/2026
Last Update Date : 03/16/2026

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