MEDICARE: JOHN SUTHERLAND MD

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	207RC0000X	Cardiovascular Disease Physician	27081	AZ
2	207R00000X	Internal Medicine Physician	27081	AZ
3	207RB0002X	Obesity Medicine (Internal Medicine) Physician	27081	AZ

Medicare Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	060049547	OTHER	AZ	RAILROAD MEDICARE

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
2	WCSKQ	OTHER	AZ	SUN HEALTH GROUP #
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1447251848
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JOHN SUTHERLAND MD

Provider Business Mailing Address
First Line	:	9812 N 7TH ST
Second Line	:	SUITE 7
City	:	PHOENIX
State	:	AZ
Zip	:	85020-1763
Country	:	US
Telephone Number	:	602-714-6783
Fax Number	:

Provider Business Practice Location Address
First Line	:	9812 N 7TH ST
Second Line	:	SUITE 7
City	:	PHOENIX
State	:	AZ
Zip	:	85020-1763
Country	:	US
Telephone Number	:	602-714-6783
Fax Number	:

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

Provider Enumeration Date	:	08/09/2005
Last Update Date	:	10/24/2014

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Directions to “ JOHN SUTHERLAND MD” Practice Location

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