Provider Demographics
NPI:1508826918
Name:SUTTON, DAVID P (MD)
Entity Type:Individual
Prefix:MR
First Name:DAVID
Middle Name:P
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 1:2525 COUNTY HIGHWAY I
Mailing Address - Street 2:
Mailing Address - City:CHIPPEWA FALLS
Mailing Address - State:WI
Mailing Address - Zip Code:54729-1422
Mailing Address - Country:US
Mailing Address - Phone:715-723-9375
Mailing Address - Fax:715-723-1092
Practice Address - Street 1:2525 COUNTY HIGHWAY I
Practice Address - Street 2:
Practice Address - City:CHIPPEWA FALLS
Practice Address - State:WI
Practice Address - Zip Code:54729-1422
Practice Address - Country:US
Practice Address - Phone:715-723-9375
Practice Address - Fax:715-723-1092
Is Sole Proprietor?:No
Enumeration Date:2006-03-28
Last Update Date:2021-12-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZ35147207W00000X
IL036120295207W00000X
WI29034-20207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
ILF400374739OtherMEDICARE
IL036120295Medicaid