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General NPI Number Information
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NPI Number | 1477734275
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Entity Type | Organization
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Legal Business Name | SUTTON MEDICAL SERVICES, LLC
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Dates
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Enumeration Date | 11/20/2007
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Last Update Date | 11/20/2007
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Provider Practice Location Address
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Address Line | 1314 E WALNUT ST
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City | WASHINGTON
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State | IN
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Zip | 47501-2860
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Country | US
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Telephone | 812-254-7310
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 431
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City | WASHINGTON
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State | IN
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Zip | 47501-0431
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Country | US
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Telephone | 812-254-7310
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. LARRY W SUTTON
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Credential | D.O.
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Telephone | 812-254-2760
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 273Y00000X
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Taxonomy Name | Rehabilitation Hospital Unit
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License Number | 02000751A
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License Number State | IN
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