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Organization
CHARLES L CUTLER, M.D., P.A.
Active
Organization
CHARLES L CUTLER, M.D., P.A.
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MR. CHARLES LEO CUTLER M.D. (PRES)
(208) 734-0337
Entity
Organization
Contact information
Practice address
630 ADDISON AVE W STE 220, TWIN FALLS, ID 83301-5474
(208) 734-0337
(208) 733-3561
Mailing address
630 ADDISON AVE W STE 220, TWIN FALLS, ID 83301-5474
(208) 734-0337
(208) 733-3561
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
M3817
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
002485700
—
ID
01
—
38174
BLUE CROSS
ID
Enumeration date
01/06/2010
Last updated
01/06/2010
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