Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207RC0000X | Internist - Cardiovascular Disease | 44728 | KY |
N | 207RC0001X | Clinical Cardiac Electrophysiologist | 44728 | KY |
NPI | 1023156072 |
---|---|
Provider Name | Brad Steven Sutton |
First Address | Louisville, KY 40201-0909 |
Second Address | Louisville, KY 40202-5703 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 02/02/2007 |
Last Update Date | 01/12/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
201039220 | (05) | IN |
7100179840 | (05) | KY |