Healthcare Provider Details

I. General information

NPI: 1043218225
Provider Name (Legal Business Name): MARGARET K SUTTON MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: MARGARET KONTRAS MD

II. Dates (important events)

Enumeration Date: 07/12/2005
Last Update Date: 02/20/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

7100 STEPHANIE LN STE 100
LINCOLN NE
68516-5332
US

IV. Provider business mailing address

PO BOX 6068
LINCOLN NE
68506-0068
US

V. Phone/Fax

Practice location:
  • Phone: 402-484-9009
  • Fax: 402-483-4223
Mailing address:
  • Phone: 402-484-9009
  • Fax: 402-483-4223

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207N00000X
TaxonomyDermatology Physician
License Number15459
License Number StateNE
# 2
Primary TaxonomyN
Taxonomy Code207ND0900X
TaxonomyDermatopathology Physician
License Number15459
License Number StateNE
# 3
Primary TaxonomyN
Taxonomy Code207NS0135X
TaxonomyProcedural Dermatology Physician
License Number15459
License Number StateNE

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: