Provider Demographics
NPI:1689771859
Name:SUTTON, JOHN HATLEY (OD)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:HATLEY
Last Name:SUTTON
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
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Mailing Address - Street 1:1703 LAKESIDE DR
Mailing Address - Street 2:1703 LAKESIDE DR
Mailing Address - City:RENO
Mailing Address - State:NV
Mailing Address - Zip Code:89509-3409
Mailing Address - Country:US
Mailing Address - Phone:775-323-1680
Mailing Address - Fax:775-323-2119
Practice Address - Street 1:1703 LAKESIDE DR
Practice Address - Street 2:1703 LAKESIDE DR
Practice Address - City:RENO
Practice Address - State:NV
Practice Address - Zip Code:89509-3409
Practice Address - Country:US
Practice Address - Phone:775-323-1680
Practice Address - Fax:775-323-2119
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-20
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NV146152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist