Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
N | 207RC0000X | Internist - Cardiovascular Disease | 036-104112 | IL |
N | 207RC0000X | Internist - Cardiovascular Disease | 35.062371 | OH |
Y | 207RI0011X | Interventional Cardiology | 35062371 | OH |
NPI | 1013926765 |
---|---|
Provider Name | Dr. Joseph M. Sutton |
First Address | Columbus, OH 43260-0001 |
Second Address | Marion, OH 43302-6416 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 05/08/2006 |
Last Update Date | 25/02/2015 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
060062999 | RAILROAD MEDICARE (01) | IL |
0879732 | (05) | OH |
1013926765 1 | (05) | IL |
279500 | MEDICARE GROUP (01) | IL |
F04725 | (02) | IL |