Charles L Cutler, M.D., P.a.

Primary specialty

SpecialistTaxonomy code 174400000X

License

M3817 Issued in ID

Legal business name

CHARLES L CUTLER, M.D., P.A.

Practice address

630 Addison Ave W Ste 220
Twin Falls, ID 83301-5474

Phone

(208) 734-0337

Fax

(208) 733-3561

NPI assigned

Jan 6, 2010

Organization subpart

No

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

Authorized official

Name

Mr. Charles Leo Cutler, M.D.

Title

Pres

Phone

(208) 734-0337

Specialties & licenses 1

Addresses

Other identifiers 2

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

{
    "created_epoch": "1262736000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1262736000000",
    "number": "1407186893",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "630 ADDISON AVE W STE 220",
            "city": "TWIN FALLS",
            "state": "ID",
            "postal_code": "833015474",
            "telephone_number": "208-734-0337",
            "fax_number": "208-733-3561"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "630 ADDISON AVE W STE 220",
            "city": "TWIN FALLS",
            "state": "ID",
            "postal_code": "833015474",
            "telephone_number": "208-734-0337",
            "fax_number": "208-733-3561"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHARLES L CUTLER, M.D., P.A.",
        "organizational_subpart": "NO",
        "enumeration_date": "2010-01-06",
        "last_updated": "2010-01-06",
        "status": "A",
        "authorized_official_last_name": "CUTLER",
        "authorized_official_first_name": "CHARLES",
        "authorized_official_middle_name": "LEO",
        "authorized_official_title_or_position": "PRES",
        "authorized_official_telephone_number": "208-734-0337",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "M.D."
    },
    "taxonomies": [
        {
            "code": "174400000X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Specialist",
            "state": "ID",
            "license": "M3817",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "002485700",
            "state": "ID"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BLUE CROSS",
            "identifier": "38174",
            "state": "ID"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 2010; 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.