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1053786319 NPI number — EDWARD SUTTON JR.

NPI Number: 1053786319
Health Care Provider/Practitioner: EDWARD SUTTON JR.

Information about “1053786319” NPI (EDWARD SUTTON JR.) exists in 1053786319 in HTML format HTML  |  1053786319 in plain Text format TXT  |  1053786319 in PDF (Portable Document Format) PDF  |  1053786319 in an XML format XML  formats.

NPI Number : 1053786319 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1053786319",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "SUTTON",
    "FirstName": "EDWARD",
    "MiddleName": null,
    "NamePrefix": null,
    "NameSuffix": "JR.",
    "Credential": null,
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "5501 OLD YORK ROAD",
    "SecondLineMailingAddress": "EINSTEIN MEDICAL CENTER TABOR EMERGENCY PHYSICIANS",
    "MailingAddressCityName": "PHILADELPHIA",
    "MailingAddressStateName": "PA",
    "MailingAddressPostalCode": "19141",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "215-456-8037",
    "MailingAddressFaxNumber": "215-456-8502",
    "FirstLinePracticeLocationAddress": "5501 OLD YORK ROAD",
    "SecondLinePracticeLocationAddress": "EINSTEINMEDICAL CENTER TABOR EMERGENCY PHYSICIANS",
    "PracticeLocationAddressCityName": "PHILADELPHIA",
    "PracticeLocationAddressStateName": "PA",
    "PracticeLocationAddressPostalCode": "19141",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "215-456-8037",
    "PracticeLocationAddressFaxNumber": "215-456-8502",
    "EnumerationDate": "12/11/2015",
    "LastUpdateDate": "12/11/2015",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "M",
    "Gender": "Male",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": {
        "TaxonomyCode": "363A00000X",
        "TaxonomyName": "Physician Assistant",
        "LicenseNumber": "MA057993",
        "LicenseNumberStateCode": "PA",
        "PrimaryTaxonomySwitch": "Y"
      }
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

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