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NPI Code Detail

MEDICARE: JOHN R SUTTON DO

MEDICARE:   JOHN R SUTTON  DO
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
1207RE0101XEndocrinology, Diabetes & Metabolism Physician1092NV

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1P00112192OTHERNVRAIL ROAD MEDICARE ID #

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
2CC5847OTHERNVBCBS ID NUMBER

General Provider Information

NPI Number : 1801812631
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOHN R SUTTON DO
Provider Business Mailing Address
First Line : 1177 N DIVISION ST
Second Line : #3
City : CARSON CITY
State : NV
Zip : 89703-3805
Country : US
Telephone Number : 775-841-6333
Fax Number : 775-841-3304
Provider Business Practice Location Address
First Line : 1177 N DIVISION ST
Second Line : #3
City : CARSON CITY
State : NV
Zip : 89703-3805
Country : US
Telephone Number : 775-841-6333
Fax Number : 775-841-3304
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/14/2006
Last Update Date : 07/09/2007

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Directions to “ JOHN R SUTTON DO” Practice Location

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