Provider Demographics
NPI:1407802283
Name:SUTTON, GEORGE S (MD)
Entity type:Individual
Prefix:DR
First Name:GEORGE
Middle Name:S
Last Name:SUTTON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:3737 GOVERNMENT BLVD
Mailing Address - Street 2:SUITE 408
Mailing Address - City:MOBILE
Mailing Address - State:AL
Mailing Address - Zip Code:36693-4308
Mailing Address - Country:US
Mailing Address - Phone:251-602-1911
Mailing Address - Fax:251-602-1850
Practice Address - Street 1:3737 GOVERNMENT BLVD
Practice Address - Street 2:SUITE 408
Practice Address - City:MOBILE
Practice Address - State:AL
Practice Address - Zip Code:36693-4308
Practice Address - Country:US
Practice Address - Phone:251-602-1911
Practice Address - Fax:251-602-1850
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-25
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
AL6257207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL51085738OtherBCBS ID
ALI208OtherMEDICARE GROUP NUMBER
AL6257OtherSTATE LICENSE #
ALAS5546087OtherDEA#
ALC72846Medicare UPIN