Provider Demographics
NPI:1427041722
Name:SUTTON, JUDITH H (MD)
Entity Type:Individual
Prefix:DR
First Name:JUDITH
Middle Name:H
Last Name:SUTTON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8902 N MERIDIAN ST
Mailing Address - Street 2:SUITE 230
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46260-5382
Mailing Address - Country:US
Mailing Address - Phone:317-581-8888
Mailing Address - Fax:317-705-7178
Practice Address - Street 1:8902 N MERIDIAN ST
Practice Address - Street 2:SUITE 230
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46260-5382
Practice Address - Country:US
Practice Address - Phone:317-581-8888
Practice Address - Fax:317-705-7178
Is Sole Proprietor?:No
Enumeration Date:2005-08-23
Last Update Date:2012-07-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01033429207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN000000219231OtherANTHEM
IN100216290Medicaid
IN100216290Medicaid
IN190530EMedicare PIN
IN080186067Medicare PIN