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NPI Code Detail

MEDICARE: DR. THOMAS PARK SUTTON O.D.

MEDICARE: DR. THOMAS PARK SUTTON O.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
1152W00000XOptometrist1075CO

General Provider Information

NPI Number : 1548269319
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. THOMAS PARK SUTTON O.D.
Provider Business Mailing Address
First Line : 1130 LAKE PLAZA DR
Second Line : SUITE 230
City : COLORADO SPRINGS
State : CO
Zip : 80906-3594
Country : US
Telephone Number : 719-219-3819
Fax Number : 719-219-0411
Provider Business Practice Location Address
First Line : 1130 LAKE PLAZA DR
Second Line : SUITE 230
City : COLORADO SPRINGS
State : CO
Zip : 80906-3594
Country : US
Telephone Number : 719-219-3819
Fax Number : 719-219-0411
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/14/2005
Last Update Date : 06/01/2015

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Directions to “ DR. THOMAS PARK SUTTON O.D.” Practice Location

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