Individual
DR. JOHN E SUTPHIN JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
7400 STATE LINE RD, SUITE 100, PRAIRIE VILLAGE, KS 66208-3444
(913) 588-6600
(913) 588-6655
Mailing address
PO BOX 411851, KANSAS CITY, MO 64141-1851
(913) 588-6606
(913) 588-0888
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
0432154
KS
207W00000X
Ophthalmology Physician
29191
IA
207W00000X
Ophthalmology Physician
G2860
TX
207WX0120X
Cornea and External Diseases Specialist Physician
0432154
KS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
12483
WELLMARCK BCBS
IA
05
—
2007407810A
—
KS
01
—
E97E868A
MEDICARE
KS
Enumeration date
08/09/2005
Last updated
10/28/2020
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