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Individual

JOHN PAUL SUTKOWSKI

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
350 W COLUMBIA ST, SUITE 420, EVANSVILLE, IN 47710-1782
(812) 422-3254
(812) 426-6388
Mailing address
350 W COLUMBIA ST, SUITE 420, EVANSVILLE, IN 47710-1782
(812) 422-3254
(812) 426-6388

Taxonomy

Speciality
Code
Description
License number
State
2085R0202X
Diagnostic Radiology Physician
Primary
01057828A
IN

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
200444930
IN
05
64068794
KY
01
P00035360
RAILROAD MEDICARE
IN
01
P00035389
RAILROAD MEDICARE
IN
01
P00086100
RAILROAD MEDICARE
IN
Enumeration date
10/04/2005
Last updated
06/12/2014
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