Healthcare Provider Details

I. General information

NPI: 1144258138
Provider Name (Legal Business Name): PATRICIA LYNN SUTTON D.O.
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/29/2006
Last Update Date: 05/06/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

425 CHESTER PIKE
NORWOOD PA
19074-1414
US

IV. Provider business mailing address

425 CHESTER PIKE P.O. BOX 9
NORWOOD PA
19074-1414
US

V. Phone/Fax

Practice location:
  • Phone: 610-532-0646
  • Fax: 610-532-1252
Mailing address:
  • Phone: 610-532-0646
  • Fax: 610-532-1252

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberOS-005269L
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: