Provider Demographics
NPI:1801812631
Name:SUTTON, JOHN R (DO)
Entity type:Individual
Prefix:
First Name:JOHN
Middle Name:R
Last Name:SUTTON
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:1177 N DIVISION ST
Mailing Address - Street 2:#3
Mailing Address - City:CARSON CITY
Mailing Address - State:NV
Mailing Address - Zip Code:89703-3805
Mailing Address - Country:US
Mailing Address - Phone:775-841-6333
Mailing Address - Fax:775-841-3304
Practice Address - Street 1:1177 N DIVISION ST
Practice Address - Street 2:#3
Practice Address - City:CARSON CITY
Practice Address - State:NV
Practice Address - Zip Code:89703-3805
Practice Address - Country:US
Practice Address - Phone:775-841-6333
Practice Address - Fax:775-841-3304
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-14
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
NV1092207RE0101X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RE0101XAllopathic & Osteopathic PhysiciansInternal MedicineEndocrinology, Diabetes & Metabolism
Provider Identifiers
StateIdentifier IDID TypeIssuer
NVP00112192OtherRAIL ROAD MEDICARE ID #
NVCC5847OtherBCBS ID NUMBER
NVCC5847OtherBCBS ID NUMBER