Provider Demographics
NPI:1336252774
Name:SUTTON, JAMES DAVID (MD)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:DAVID
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 1:3631 BIENVILLE BLVD
Mailing Address - Street 2:
Mailing Address - City:OCEAN SPRINGS
Mailing Address - State:MS
Mailing Address - Zip Code:39564
Mailing Address - Country:US
Mailing Address - Phone:228-875-2020
Mailing Address - Fax:228-875-2036
Practice Address - Street 1:3631 BIENVILLE BLVD
Practice Address - Street 2:
Practice Address - City:OCEAN SPRINGS
Practice Address - State:MS
Practice Address - Zip Code:39564
Practice Address - Country:US
Practice Address - Phone:228-875-2020
Practice Address - Fax:228-875-2036
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-17
Last Update Date:2008-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS12585207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MS00017346Medicaid
MS180008513OtherRAILROAD MEDICARE
MS00017346Medicaid
MS0727040001Medicare NSC
MS180000077Medicare PIN