MEDICARE: JAMES R. SUTTON P.A.-C

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	363A00000X	Physician Assistant	50-00-2237	OH

General Provider Information

NPI Number	:	1992702609
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAMES R. SUTTON P.A.-C

Provider Business Mailing Address
First Line	:	10506 MONTGOMERY RD STE 200A
Second Line	:
City	:	MONTGOMERY
State	:	OH
Zip	:	45242-4400
Country	:	US
Telephone Number	:	513-246-2343
Fax Number	:	513-985-2905

Provider Business Practice Location Address
First Line	:	10506 MONTGOMERY RD STE 200A
Second Line	:
City	:	MONTGOMERY
State	:	OH
Zip	:	45242-4400
Country	:	US
Telephone Number	:	513-246-2343
Fax Number	:	513-985-2905

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

Provider Enumeration Date	:	07/07/2005
Last Update Date	:	08/21/2025

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