MEDICARE: TODD MONTE SAUTTER DPM

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	390200000X	Student in an Organized Health Care Education/Training Program	TBD	OH
2	213ES0103X	Foot & Ankle Surgery Podiatrist	DP209583	OR

General Provider Information

NPI Number	:	1063974012
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TODD MONTE SAUTTER DPM

Provider Business Mailing Address
First Line	:	1227 NE 7TH ST STE A
Second Line	:
City	:	GRANTS PASS
State	:	OR
Zip	:	97526-1430
Country	:	US
Telephone Number	:	541-471-3668
Fax Number	:

Provider Business Practice Location Address
First Line	:	1227 NE 7TH ST STE A
Second Line	:
City	:	GRANTS PASS
State	:	OR
Zip	:	97526-1430
Country	:	US
Telephone Number	:	541-471-3668
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	04/01/2019
Last Update Date	:	08/03/2023

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Directions to “ TODD MONTE SAUTTER DPM” Practice Location

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