Healthcare Provider Details

I. General information

NPI: 1619893252
Provider Name (Legal Business Name): SUTTON STEWART
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/27/2026
Last Update Date: 06/27/2026
Certification Date: 06/27/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

900 N 7TH ST
WEST MEMPHIS AR
72301-2001
US

IV. Provider business mailing address

6165 CEDAR GROVE RD
ARLINGTON TN
38002-6917
US

V. Phone/Fax

Practice location:
  • Phone: 870-735-3842
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code122300000X
TaxonomyDentist
License Number4945
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: