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General NPI Number Information
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NPI Number | 1730261991
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Entity Type | Individual
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Provider Name | KYRSTEN E SUTTON MD
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Gender | Female
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Dates
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Enumeration Date | 10/19/2006
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Last Update Date | 12/23/2020
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Provider Practice Location Address
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Address Line | 891 W MAIN ST STE 500
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City | DOVER FOXCROFT
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State | ME
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Zip | 04426-1064
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Country | US
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Telephone | 207-564-4470
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Fax | 207-564-4468
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Provider Business Mailing Address
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Address Line | 891 W MAIN ST
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City | DOVER FOXCROFT
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State | ME
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Zip | 04426-1059
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Country | US
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Telephone | 207-564-4470
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Fax | 207-564-4468
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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 | 207VG0400X
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Taxonomy Name | Gynecology Physician
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License Number | MD20778
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License Number State | ME
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Taxonomy #2
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Taxonomy Code | 207VG0400X
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Taxonomy Name | Gynecology Physician
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License Number | 22119
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License Number State | SC
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Taxonomy #3
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Taxonomy Code | 207VX0000X
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Taxonomy Name | Obstetrics Physician
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License Number | 22119
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License Number State | SC
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Taxonomy #4
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Taxonomy Code | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | MD20778
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License Number State | ME
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Taxonomy #5
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Taxonomy Code | 207V00000X
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Taxonomy Name | Obstetrics & Gynecology Physician
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License Number | 22119
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License Number State | SC
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