Provider Demographics
NPI:1275705485
Name:KELLY, SUZANNE KUTTLER (DO)
Entity Type:Individual
Prefix:DR
First Name:SUZANNE
Middle Name:KUTTLER
Last Name:KELLY
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:800 W STATE ST STE 201
Mailing Address - Street 2:
Mailing Address - City:DOYLESTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18901-5842
Mailing Address - Country:US
Mailing Address - Phone:215-348-4478
Mailing Address - Fax:215-348-2452
Practice Address - Street 1:800 W STATE ST STE 201
Practice Address - Street 2:
Practice Address - City:DOYLESTOWN
Practice Address - State:PA
Practice Address - Zip Code:18901-5842
Practice Address - Country:US
Practice Address - Phone:215-348-4478
Practice Address - Fax:215-348-2452
Is Sole Proprietor?:No
Enumeration Date:2008-03-27
Last Update Date:2023-06-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAOS014292207Q00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine