MEDICARE: DR. JANET K SUTTON D.O.

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	207QG0300X	Geriatric Medicine (Family Medicine) Physician	JS007695	MI

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1891795878
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JANET K SUTTON D.O.

Provider Business Mailing Address
First Line	:	2200 GROVELAND RD
Second Line	:
City	:	BAY CITY
State	:	MI
Zip	:	48708-6325
Country	:	US
Telephone Number	:	989-667-6780
Fax Number	:	989-667-6218

Provider Business Practice Location Address
First Line	:	4817 PROFESSIONAL CT
Second Line	:
City	:	BAY CITY
State	:	MI
Zip	:	48706-2839
Country	:	US
Telephone Number	:	989-667-6780
Fax Number	:	989-667-6218

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

Provider Enumeration Date	:	07/30/2005
Last Update Date	:	04/09/2012

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