Provider Demographics
NPI:1700826815
Name:SUTTON, WILLIAM CHARLES (DPM)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:CHARLES
Last Name:SUTTON
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4801 SWIFT RD
Mailing Address - Street 2:SUITE F
Mailing Address - City:SARASOTA
Mailing Address - State:FL
Mailing Address - Zip Code:34231-5139
Mailing Address - Country:US
Mailing Address - Phone:941-921-3000
Mailing Address - Fax:941-921-3066
Practice Address - Street 1:4801 SWIFT RD
Practice Address - Street 2:SUITE F
Practice Address - City:SARASOTA
Practice Address - State:FL
Practice Address - Zip Code:34231-5139
Practice Address - Country:US
Practice Address - Phone:941-921-3000
Practice Address - Fax:941-921-3066
Is Sole Proprietor?:No
Enumeration Date:2006-06-07
Last Update Date:2008-09-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPO-3158213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
FL65874OtherBCBS
FL340484600Medicaid
FLV01867Medicare UPIN
FL340484600Medicaid
FLU3574Medicare ID - Type Unspecified
FLU3574ZMedicare PIN