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General NPI Number Information
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NPI Number | 1396925541
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Entity Type | Individual
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Provider Name | LAIRD DAVID CARUTHERS M.D.
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Gender | Male
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Dates
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Enumeration Date | 11/05/2007
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Last Update Date | 03/07/2023
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Provider Practice Location Address
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Address Line | 15301 TYLER FOOTE RD
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City | NEVADA CITY
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State | CA
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Zip | 95959-9318
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Country | US
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Telephone | 530-292-3478
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Fax | 530-292-4296
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Provider Business Mailing Address
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Address Line | 15301 TYLER FOOTE RD
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City | NEVADA CITY
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State | CA
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Zip | 95959-9318
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Country | US
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Telephone | 530-292-3478
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Fax | 530-292-4296
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | 38245
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License Number State | TN
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Taxonomy #2
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | C-6389
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License Number State | AR
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