Provider Demographics
NPI:1144409871
Name:SUTTON, STEPHEN PAUL (MD)
Entity Type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:PAUL
Last Name:SUTTON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:1050 ISAAC STREETS DR
Mailing Address - Street 2:#126
Mailing Address - City:OREGON
Mailing Address - State:OH
Mailing Address - Zip Code:43616-3291
Mailing Address - Country:US
Mailing Address - Phone:419-698-2020
Mailing Address - Fax:419-698-1520
Practice Address - Street 1:1050 ISAAC STREETS DR
Practice Address - Street 2:#126
Practice Address - City:OREGON
Practice Address - State:OH
Practice Address - Zip Code:43616-3291
Practice Address - Country:US
Practice Address - Phone:419-698-2020
Practice Address - Fax:419-698-1520
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-30
Last Update Date:2007-10-30
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
OH35043749S208800000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208800000XAllopathic & Osteopathic PhysiciansUrology
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0419176Medicaid
OH30037121200OtherHMO
OH00555OtherPARAMOUNT
OH30037121200OtherHMO
OHA79328Medicare UPIN