Healthcare Provider Details

I. General information

NPI: 1144089236
Provider Name (Legal Business Name): KOREY SUTTON DO
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/19/2024
Last Update Date: 06/24/2026
Certification Date: 06/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

510 RECOVERY RD STE 257
NASHVILLE TN
37211-4874
US

IV. Provider business mailing address

510 RECOVERY RD STE 257
NASHVILLE TN
37211-4874
US

V. Phone/Fax

Practice location:
  • Phone: 615-781-4430
  • Fax:
Mailing address:
  • Phone: 615-781-4430
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number6708
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: