Healthcare Provider Details

I. General information

NPI: 1285709329
Provider Name (Legal Business Name): JOHN EDWARD SUTTON JR. MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/22/2006
Last Update Date: 07/24/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

DARTMOUTH-HITCHCOCK MEDICAL CENTER ONE MEDICAL CENTER DRIVE
LEBANON NH
03756
US

IV. Provider business mailing address

DARTMOUTH-HITCHCOCK MEDICAL CENTER ONE MEDICAL CENTER DRIVE
LEBANON NH
03756
US

V. Phone/Fax

Practice location:
  • Phone: 603-650-8022
  • Fax: 603-650-8030
Mailing address:
  • Phone: 603-650-8022
  • Fax: 603-650-8030

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number6413
License Number StateNH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: