Provider Demographics
NPI:1326244708
Name:SUTTON, JARRETT HEATH (MD)
Entity Type:Individual
Prefix:DR
First Name:JARRETT
Middle Name:HEATH
Last Name:SUTTON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1805 SCOTTSVILLE RD
Mailing Address - Street 2:
Mailing Address - City:BOWLING GREEN
Mailing Address - State:KY
Mailing Address - Zip Code:42104-3301
Mailing Address - Country:US
Mailing Address - Phone:270-781-3415
Mailing Address - Fax:270-781-2091
Practice Address - Street 1:1805 SCOTTSVILLE RD
Practice Address - Street 2:
Practice Address - City:BOWLING GREEN
Practice Address - State:KY
Practice Address - Zip Code:42104-3301
Practice Address - Country:US
Practice Address - Phone:270-781-3415
Practice Address - Fax:270-781-2091
Is Sole Proprietor?:No
Enumeration Date:2007-06-22
Last Update Date:2012-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY41154207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY31000458Medicaid
000000529953OtherANTHEM BCBS
KY0322516Medicare PIN
000000529953OtherANTHEM BCBS