Robert Clyde Northcutt, MD
Individual provider Active NPI Endocrinology, Diabetes & Metabolism Physician · Concan, TX
NPI 1467685487 · NPPES record last updated Jan 12, 2011
Key facts
- NPI
- 1467685487
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Endocrinology, Diabetes & Metabolism Physician 207RE0101X
- License
- 20405 (MN)
- Practice address
- 186 Frio Canyon Road
Concan, TX 78838-0001 - Phone
- (830) 232-4797
- NPI assigned
- Aug 25, 2009
- Sex
- Male
- Sole proprietor
- Yes
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
- Credentials
- Doctor of Medicine
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 23169 | AZ | MD | Mental Health Counselor |
| 20405 | MN | MD | Endocrinology, Diabetes & Metabolism Physician |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Endocrinology, Diabetes & Metabolism Physician | 207RE0101X | 20405 | MN | Yes |
Addresses
Primary practice location
186 Frio Canyon Road
Concan, TX 78838-0001
Mailing address
PO Box 17
186 Frio Canyon Road
Concan, TX 78838-0001
Phone (830) 232-4797
Other providers in Concan, TX
All providers in Concan, TX · Endocrinology, Diabetes & Metabolism Physician in Texas
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jan 12, 2011. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.