Healthcare Provider Details
I. General information
NPI: 1366545709
Provider Name (Legal Business Name): KARRI DANIELLE DUTTON MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 09/07/2006
Last Update Date: 05/19/2023
Certification Date: 05/19/2023
Deactivation Date:
Reactivation Date:
III. Provider practice location address
3001 FM 2181 STE 300
CORINTH TX
76210
US
IV. Provider business mailing address
3001 FM 2181 STE 300
CORINTH TX
76210
US
V. Phone/Fax
- Phone: 940-497-4900
- Fax: 940-497-4901
- Phone: 940-497-4900
- Fax: 940-497-4901
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 208000000X |
| Taxonomy | Pediatrics Physician |
| License Number | J6936 |
| License Number State | TX |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: