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NPI Code Detail

MEDICARE: SUTTON BARROW

MEDICARE: SUTTON BARROW
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
1101Y00000XCounselor

General Provider Information

NPI Number : 1861209330
Entity Type Code : Individual
Provider Name (Legal Business Name) : SUTTON BARROW
Provider Business Mailing Address
First Line : 200 TECH CENTER DR
Second Line :
City : KNOXVILLE
State : TN
Zip : 37912-2747
Country : US
Telephone Number : 865-637-9711
Fax Number :
Provider Business Practice Location Address
First Line : 5645 MERCHANTS CENTER BLVD STE 101
Second Line :
City : KNOXVILLE
State : TN
Zip : 37912-3473
Country : US
Telephone Number : 865-483-7743
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 12/17/2024
Last Update Date : 12/17/2024

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Directions to “ SUTTON BARROW ” Practice Location

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