1225679830 NPI number — MRS. EMMALYNNE BESSE SUTTON D.C.

Table of content: MRS. EMMALYNNE BESSE SUTTON D.C. (NPI 1225679830)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1225679830 NPI number — MRS. EMMALYNNE BESSE SUTTON D.C.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SUTTON
Provider First Name:
EMMALYNNE
Provider Middle Name:
BESSE
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
D.C.
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
SPLICHAL
Provider Other First Name:
EMMALYNNE
Provider Other Middle Name:
BESSE
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
D.C.
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1225679830
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
01/26/2023
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
ADA FAMILY CHIROPRACTIC
Provider Second Line Business Mailing Address:
1214 OKLAHOMA PLAZA
Provider Business Mailing Address City Name:
ADA
Provider Business Mailing Address State Name:
OK
Provider Business Mailing Address Postal Code:
74820
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
580-436-9079
Provider Business Mailing Address Fax Number:
580-436-8204

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
ADA FAMILY CHIROPRACTIC
Provider Second Line Business Practice Location Address:
1214 OKLAHOMA PLAZA
Provider Business Practice Location Address City Name:
ADA
Provider Business Practice Location Address State Name:
OK
Provider Business Practice Location Address Postal Code:
74820
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
580-436-9079
Provider Business Practice Location Address Fax Number:
580-436-8204
Provider Enumeration Date:
10/04/2019

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 111N00000X , with the licence number:  0000000 , registered in the state of NE ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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