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NPI Code Detail

MEDICARE: TIMOTHY SUTTON MD, MPA, MA, CAS

MEDICARE: TIMOTHY SUTTON MD, MPA, MA, CAS
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
12083X0100XOccupational Medicine Physician036.141707IL
22083X0100XOccupational Medicine Physician4301096588MI
32083X0100XOccupational Medicine Physician35.135393CTROH
42083A0300XAddiction Medicine (Preventive Medicine) Physician35135393OH

General Provider Information

NPI Number : 1477871382
Entity Type Code : Individual
Provider Name (Legal Business Name) : TIMOTHY SUTTON MD, MPA, MA, CAS
Provider Business Mailing Address
First Line : 475 LEXINGTON AVE
Second Line :
City : MANSFIELD
State : OH
Zip : 44907-1501
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 475 LEXINGTON AVE
Second Line :
City : MANSFIELD
State : OH
Zip : 44907-1501
Country : US
Telephone Number : 440-666-5742
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/17/2010
Last Update Date : 02/07/2023

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