Provider Demographics
NPI:1619308855
Name:SUTTON, KIRK
Entity Type:Individual
Prefix:
First Name:KIRK
Middle Name:
Last Name:SUTTON
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6205 FARRINGTON RD
Mailing Address - Street 2:APT G4
Mailing Address - City:CHAPEL HILL
Mailing Address - State:NC
Mailing Address - Zip Code:27517-7845
Mailing Address - Country:US
Mailing Address - Phone:919-942-4343
Mailing Address - Fax:919-942-4338
Practice Address - Street 1:6205 FARRINGTON RD
Practice Address - Street 2:APT G4
Practice Address - City:CHAPEL HILL
Practice Address - State:NC
Practice Address - Zip Code:27517-7845
Practice Address - Country:US
Practice Address - Phone:919-942-4343
Practice Address - Fax:919-942-4338
Is Sole Proprietor?:Yes
Enumeration Date:2013-12-12
Last Update Date:2013-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator