Individual
DR. SAMUEL KEITH SUTTLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
14724 HIGHWAY 15 N, LOUISVILLE, MS 39339-6318
(662) 773-7500
Mailing address
8613 MS HIGHWAY 12, ACKERMAN, MS 39735-8917
(662) 285-9460
(662) 285-9324
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
08435
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
00119309
—
MS
Enumeration date
05/11/2006
Last updated
03/10/2020
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