| Mark Sutton Md Inc | |
|
121 S 7th Ave Ste A Barstow CA 92311-3059 | |
| (760) 256-1004 | |
| (760) 256-1055 |
| Full Name | Mark Sutton Md Inc |
|---|---|
| Speciality | Dermatology |
| Location | 121 S 7th Ave Ste A, Barstow, California |
| Authorized Official Name and Position | Mark Sutton (OWNER/PROVIDER) |
| Authorized Official Contact | 7602561004 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mark Sutton Md Inc 121 S 7th Ave Barstow CA 92311-3058 Ph: (760) 256-1004 | Mark Sutton Md Inc 121 S 7th Ave Ste A Barstow CA 92311-3059 Ph: (760) 256-1004 |
| NPI Number | 1003664319 |
|---|---|
| Provider Enumeration Date | 05/10/2024 |
| Last Update Date | 07/16/2024 |
| Medicare PECOS PAC ID | 3274073044 |
|---|---|
| Medicare Enrollment ID | O20240906002812 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1003664319 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 207Q00000X | Family Medicine | (* (Not Available)) | Secondary |
| 207N00000X | Dermatology | (* (Not Available)) | Primary |
| Provider Name | Mark Stephen Sutton |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1003841248 PECOS PAC ID: 9234263427 Enrollment ID: I20100810000173 |
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