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General NPI Number Information
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NPI Number | 1518784933
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Entity Type | Individual
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Provider Name | TAYLOR LANE SUTTON OD
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Gender | Female
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Dates
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Enumeration Date | 09/25/2024
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Last Update Date | 02/14/2025
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Provider Practice Location Address
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Address Line | 1607 S MAIN ST
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City | LAMAR
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State | CO
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Zip | 81052-3825
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Country | US
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Telephone | 719-496-3311
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Fax |
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Provider Business Mailing Address
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Address Line | 618 WILLOW VALLEY DR
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City | LAMAR
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State | CO
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Zip | 81052-3919
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Country | US
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Telephone | 620-453-1108
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 152W00000X
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Taxonomy Name | Optometrist
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License Number | OPT.0004076
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License Number State | CO
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