Randall Jon Suttor in South Bend - Family Medicine
Randall Jon Suttor - NPI 1609850908
Randall Jon Suttor is a Family Medicine in South Bend, Indiana. Randall Jon Suttor practices all healthcare services and medical treatments related to Family Medicine. The NPI Number for Randall Jon Suttor is 1609850908. The last update date is 2021-04-05.
Randall Jon Suttor's current location address is 714 N Michigan St, South Bend, Indiana. You can contact this provider via phone number 5746477477 and fax number 5746473655. The mailing address for Randall Jon Suttor is 714 N Michigan St, South Bend, Indiana. To know further, please read the information below!
Provider Profile Detail
| Provider Name | Randall Jon Suttor |
|---|---|
| Address | 714 N Michigan St, South Bend, Indiana |
| Phone Number | 5746477477 |
| Fax Number | 5746473655 |
| Sole Proprietor | N |
| Credentials | M.D. |
NPI Number Detail
| NPI Number | 1609850908 |
|---|---|
| Provider Enumeration Date | 2005-12-01 |
| Last Updated Date | 2021-04-05 |
Provider Mailing Address Detail
| Address | 714 N Michigan St |
|---|---|
| City | South Bend |
| State | Indiana (IN) |
| Post Code | 466011035 |
| Phone Number | 5746477477 |
| Fax Number | 5746473655 |
Provider's Primary Taxonomy Detail
| Speciality | Family Medicine |
|---|---|
| Taxonomy | 207Q00000X |
| Licence No | 01032363A |
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Definition: Family Medicine is the medical specialty which is concerned with the total health care of the individual and the family. It is the specialty in breadth which integrates the biological, clinical, and behavioral sciences. The scope of family medicine i |
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Provider's Other Legacy Identifiers
| Identifier | Identifier Type | Identifier State | Identifier Issuer |
|---|---|---|---|
| M400034991 | IN | MEDICARE PTAN | |
| 178420004 | IN | MEDICARE PTAN | |
| 100173790 | IN | -- | |
| 162520Z | IN | MEDICARE PTAN |
Post Comment/ Review Below
What is the Randall Jon Suttor's 1609850908?
The Randall Jon Suttor's NPI (National Provider Identifier) Number is 1609850908. This unique 10-digit identification number is assigned to health care providers by the Centers for Medicare & Medicaid Services (CMS).
Could you please share the complete physical address where Randall Jon Suttor is geographically located?
The Randall Jon Suttor is physically situated at the following location: 714 N Michigan St, South Bend, IN, 466011035.
What is Randall Jon Suttor's specialized field of practice, and what is the corresponding taxonomy code that categorizes this area of expertise?
The area of specialization for Randall Jon Suttor is Family Medicine, and the taxonomy code that classifies this field of practice is 207Q00000X.
On what date did the Centers for Medicare & Medicaid Services issue the 1609850908 to Randall Jon Suttor?
The Randall Jon Suttor received its 1609850908 assignment from the Centers for Medicare & Medicaid Services on 2005-12-01.
When was the information pertaining to Randall Jon Suttor most recently updated or revised?
The details related to Randall Jon Suttor, including its address, specialty, and other relevant information, were last updated or revised on 2021-04-05.