Provider Demographics
NPI:1669539060
Name:LORTON, SHARON KAY (MS, OD)
Entity type:Individual
Prefix:
First Name:SHARON
Middle Name:KAY
Last Name:LORTON
Suffix:
Gender:F
Credentials:MS, OD
Other - Prefix:DR
Other - First Name:SHARON
Other - Middle Name:K
Other - Last Name:LORTON
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:
Mailing Address - Street 1:2702 FULTON CIR
Mailing Address - Street 2:
Mailing Address - City:CLEARWATER
Mailing Address - State:MN
Mailing Address - Zip Code:55320-1304
Mailing Address - Country:US
Mailing Address - Phone:320-558-6872
Mailing Address - Fax:
Practice Address - Street 1:3950 VETERANS DR
Practice Address - Street 2:3950 VETERANS DR.
Practice Address - City:SAINT CLOUD
Practice Address - State:MN
Practice Address - Zip Code:56303-3410
Practice Address - Country:US
Practice Address - Phone:320-258-2020
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-03
Last Update Date:2007-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN2047152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist