Provider Demographics
NPI:1154552933
Name:MEYER SUTTON, M.D., APMC
Entity type:Organization
Organization Name:MEYER SUTTON, M.D., APMC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:MEYER
Authorized Official - Middle Name:
Authorized Official - Last Name:SUTTON
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:504-340-4000
Mailing Address - Street 1:1111 MEDICAL CENTER BLVD
Mailing Address - Street 2:SN513
Mailing Address - City:MARRERO
Mailing Address - State:LA
Mailing Address - Zip Code:70072-3151
Mailing Address - Country:US
Mailing Address - Phone:504-340-4000
Mailing Address - Fax:504-341-1212
Practice Address - Street 1:1111 MEDICAL CENTER BLVD
Practice Address - Street 2:SN513
Practice Address - City:MARRERO
Practice Address - State:LA
Practice Address - Zip Code:70072-3151
Practice Address - Country:US
Practice Address - Phone:504-340-4000
Practice Address - Fax:504-341-1212
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-07-28
Last Update Date:2011-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA19D0724441OtherCLIA
LA55995OtherMEDICARE
LA1042587Medicaid
LA55995OtherMEDICARE