Healthcare Provider Details

I. General information

NPI: 1386372266
Provider Name (Legal Business Name): STEPHEN ZACHARY SUTTON PHARMD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/10/2022
Last Update Date: 06/01/2026
Certification Date: 06/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

125 MAIN STREET MARKET PL SE
CARTERSVILLE GA
30121-3307
US

IV. Provider business mailing address

4011 HALISPORT VW NW
KENNESAW GA
30152-6915
US

V. Phone/Fax

Practice location:
  • Phone: 770-386-8160
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1835P0018X
TaxonomyPharmacist Clinician (PhC)/ Clinical Pharmacy Specialist
License NumberRPH033823
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: