Provider Demographics
NPI:1699712711
Name:SUTTON, SHAWN IRENE (MD)
Entity type:Individual
Prefix:DR
First Name:SHAWN
Middle Name:IRENE
Last Name:SUTTON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Suffix:
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Other - Credentials:
Mailing Address - Street 1:280 HIGHLAND DR
Mailing Address - Street 2:
Mailing Address - City:HENNIKER
Mailing Address - State:NH
Mailing Address - Zip Code:03242-4150
Mailing Address - Country:US
Mailing Address - Phone:603-724-5419
Mailing Address - Fax:
Practice Address - Street 1:80 ROUTE 125
Practice Address - Street 2:
Practice Address - City:KINGSTON
Practice Address - State:NH
Practice Address - Zip Code:03848-3535
Practice Address - Country:US
Practice Address - Phone:603-642-6700
Practice Address - Fax:603-642-6701
Is Sole Proprietor?:No
Enumeration Date:2006-05-31
Last Update Date:2023-10-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH11575207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
NHH64655Medicare UPIN