Individual
MR. JASON NATHANIEL SUTTON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
BS
Contact information
Practice address
405 E EXCELSIOR AVE, VINITA, OK 74301-4226
(918) 256-6476
(918) 256-3628
Mailing address
405 E EXCELSIOR AVE, VINITA, OK 74301-4226
(918) 256-6476
(918) 256-3628
Taxonomy
Speciality
Code
Description
License number
State
171M00000X
Case Manager/Care Coordinator
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
1659720860
—
OK
Enumeration date
06/08/2016
Last updated
06/20/2016
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