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General NPI Number Information
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NPI Number | 1538224837
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Entity Type | Individual
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Provider Name | NIRMAL K DUTTA MD
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Gender | Male
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Dates
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Enumeration Date | 12/27/2006
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Last Update Date | 12/25/2009
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Provider Practice Location Address
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Address Line | 500 BURLINGTON RD
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City | JACKSON
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State | OH
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Zip | 45640
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Country | US
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Telephone | 740-288-7784
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Fax | 740-288-4126
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Provider Business Mailing Address
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Address Line | PO BOX 193
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City | OAK HILL
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State | OH
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Zip | 45656-0193
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Country | US
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Telephone | 740-288-7784
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Fax | 740-288-4126
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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 | 208600000X
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Taxonomy Name | Surgery Physician
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License Number | 35047342
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License Number State | OH
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