Provider Demographics
NPI:1518784933
Name:SUTTON, TAYLOR LANE (OD)
Entity type:Individual
Prefix:DR
First Name:TAYLOR
Middle Name:LANE
Last Name:SUTTON
Suffix:
Gender:F
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:618 WILLOW VALLEY DR
Mailing Address - Street 2:
Mailing Address - City:LAMAR
Mailing Address - State:CO
Mailing Address - Zip Code:81052-3919
Mailing Address - Country:US
Mailing Address - Phone:620-453-1108
Mailing Address - Fax:
Practice Address - Street 1:1607 S MAIN ST
Practice Address - Street 2:
Practice Address - City:LAMAR
Practice Address - State:CO
Practice Address - Zip Code:81052-3825
Practice Address - Country:US
Practice Address - Phone:719-496-3311
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-09-25
Last Update Date:2025-02-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COOPT.0004076152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist