MEDICARE: JOHN D SUTTON M.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207RG0300X	Geriatric Medicine (Internal Medicine) Physician	14801	OK
2	173000000X	Legal Medicine		OK

General Provider Information

NPI Number	:	1184739765
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOHN D SUTTON M.D.

Provider Business Mailing Address
First Line	:	1818 KANSAS AVE
Second Line	:
City	:	WOODWARD
State	:	OK
Zip	:	73801-2912
Country	:	US
Telephone Number	:	580-254-3396
Fax Number	:	580-254-5311

Provider Business Practice Location Address
First Line	:	1818 KANSAS AVE
Second Line	:
City	:	WOODWARD
State	:	OK
Zip	:	73801-2912
Country	:	US
Telephone Number	:	580-254-3396
Fax Number	:	580-254-5311

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/21/2006
Last Update Date	:	10/21/2020

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Directions to “ JOHN D SUTTON M.D.” Practice Location

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