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General NPI Number Information
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NPI Number | 1477897726
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Entity Type | Organization
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Legal Business Name | JAMES REX CUTLER DPM PLLC
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Dates
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Enumeration Date | 11/26/2012
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Last Update Date | 11/26/2012
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Provider Practice Location Address
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Address Line | 76 E 1ST S
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City | REXBURG
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State | ID
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Zip | 83440-1936
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Country | US
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Telephone | 208-709-9912
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Fax |
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Provider Business Mailing Address
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Address Line | 76 E 1ST S
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City | REXBURG
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State | ID
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Zip | 83440-1936
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Country | US
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Telephone | 208-709-9912
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Fax |
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Authorized Official
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Title or Position | OWNER/PRESIDENT
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Name | DR. JAMES REX CUTLER
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Credential | D.P.M
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Telephone | 208-709-9912
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM2500X
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Taxonomy Name | Medical Specialty Clinic/Center
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License Number | P-219
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License Number State | ID
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