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General NPI Number Information
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NPI Number | 1558411066
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Entity Type | Individual
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Provider Name | LOREE KIMBERLY SUTTON M.D.
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Gender | Female
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Dates
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Enumeration Date | 01/10/2007
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Last Update Date | 07/08/2007
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Provider Practice Location Address
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Address Line | 36000 DARNALL LOOP
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City | FORT HOOD
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State | TX
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Zip | 76544-5095
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Country | US
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Telephone | 254-288-8001
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Fax | 254-288-8018
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Provider Business Mailing Address
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Address Line | 6777 24TH ST
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City | FORT HOOD
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State | TX
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Zip | 76544-1301
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Country | US
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Telephone | 254-289-1035
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Fax | 254-288-8018
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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 | 2084P0800X
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Taxonomy Name | Psychiatry Physician
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License Number | G-60254
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License Number State | CA
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