Doctor Name: | MRS. CAROL A SUTTON |
NPI Number: | 1659355626 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | MD |
License Number: | ME 47545 |
Business Practice Address: | 220 9th St Port St Joe, FL - 324561924 |
Business Phone Number: | 8502298244 |
Business Fax Number: | 8502296003 |
Mailing Address: | Po Box 476, 21890 Ne Cr 69a BLOUNTSTOWN |
State: | FL |
Postal Code: | 324240476 |
Phone Number: | 8506744422 |
Fax Number: | 8506744422 |
NPI Enumeration Date: | 12/02/2005 |
NPI Last Update Date: | 12/14/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 208D00000X |
License Number: | ME 47545 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | FL |
Taxonomy Type: | Allopathic & Osteopathic Physicians |
Taxonomy Classification: | General Practice |
Taxonomy Specialization: | |
Taxonomy Definition: |