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General NPI Number Information
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NPI Number | 1306034202
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Entity Type | Organization
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Legal Business Name | J. TODD CARRUTHERS, MD, PA
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Dates
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Enumeration Date | 10/05/2007
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Last Update Date | 08/08/2018
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Provider Practice Location Address
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Address Line | 1120 RAINTREE CIRCLE SUITE 210
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City | ALLEN
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State | TX
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Zip | 75013
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Country | US
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Telephone | 972-852-1534
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Fax | 972-982-7459
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Provider Business Mailing Address
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Address Line | 1120 RAINTREE CIRCLE SUITE 210
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City | ALLEN
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State | TX
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Zip | 75013
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Country | US
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Telephone | 972-852-1534
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Fax | 972-982-7459
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. JEFFREY TODD CARRUTHERS
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Credential | M.D.
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Telephone | 972-852-1534
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | K5849
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License Number State | TX
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