Organization
VERDANT HEALTHCARE LLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. DWIGHT HOWELL SUTTON MD (OWNER)
(270) 780-3546
Entity
Organization
Contact information
Practice address
1300 ANDREA ST, SUITE 100, BOWLING GREEN, KY 42104-3382
(270) 780-3546
(270) 780-3547
Mailing address
1300 ANDREA ST, SUITE 100, BOWLING GREEN, KY 42104-3382
(270) 780-3546
(270) 780-3547
Taxonomy
Speciality
Code
Description
License number
State
261QP2300X
Primary Care Clinic/Center
Primary
40753
KY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
7100017480
—
KY
Enumeration date
09/15/2016
Last updated
11/08/2016
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