E. Sutphen MD LLC

Primary specialty

Radiation Oncology PhysicianTaxonomy code 2085R0001X

License

R2P24 Issued in MO

Legal business name

E. SUTPHEN MD LLC

Practice address

10010 Kennerly Rd
Saint Louis, MO 63128-2106

Phone

(314) 525-1688

Fax

(314) 525-1689

NPI assigned

Feb 1, 2006

Last updated

Jun 10, 2009By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Dr. Eric Sutphen, MD

Title

Delegated Official

Phone

(314) 525-1688

Specialties & licenses 1

Addresses

Other identifiers 2

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Veena Kunigal, MD

  • Radiation Oncology Physician
  • Saint Louis, MO
  • NPI 1669443248
  NPD (past)
• James Marks, MD

  • Radiation Oncology Physician
  • Saint Louis, MO
  • NPI 1033237003
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1138752000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1244592000000",
    "number": "1144291659",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "10010 KENNERLY RD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631282106",
            "telephone_number": "314-525-1688",
            "fax_number": "314-525-1689"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10010 KENNERLY RD",
            "city": "SAINT LOUIS",
            "state": "MO",
            "postal_code": "631282106",
            "telephone_number": "314-525-1688",
            "fax_number": "314-525-1689"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "E. SUTPHEN MD LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-02-01",
        "last_updated": "2009-06-10",
        "status": "A",
        "authorized_official_last_name": "SUTPHEN",
        "authorized_official_first_name": "ERIC",
        "authorized_official_title_or_position": "DELEGATED OFFICIAL",
        "authorized_official_telephone_number": "314-525-1688",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "2085R0001X",
            "taxonomy_group": "",
            "desc": "Radiology, Radiation Oncology",
            "state": "MO",
            "license": "R2P24",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "507584704",
            "state": "MO"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RAILROAD MEDICARE",
            "identifier": "DC0795",
            "state": "MO"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• Radiation Oncology Physician in Saint Louis, MO
• Providers in Saint Louis, MO by specialty
• Radiation Oncology Physician in Missouri

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.