Provider Demographics
NPI:1891795878
Name:SUTTON, JANET K (DO)
Entity Type:Individual
Prefix:DR
First Name:JANET
Middle Name:K
Last Name:SUTTON
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2200 GROVELAND RD
Mailing Address - Street 2:
Mailing Address - City:BAY CITY
Mailing Address - State:MI
Mailing Address - Zip Code:48708-6325
Mailing Address - Country:US
Mailing Address - Phone:989-667-6780
Mailing Address - Fax:989-667-6218
Practice Address - Street 1:4817 PROFESSIONAL CT
Practice Address - Street 2:
Practice Address - City:BAY CITY
Practice Address - State:MI
Practice Address - Zip Code:48706-2839
Practice Address - Country:US
Practice Address - Phone:989-667-6780
Practice Address - Fax:989-667-6218
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-30
Last Update Date:2012-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MIJS007695207QG0300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207QG0300XAllopathic & Osteopathic PhysiciansFamily MedicineGeriatric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
MI4289409Medicaid
MI4289409Medicaid
MIE72675Medicare UPIN