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Individual

DR. DAVID D CLUTTS

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
2601 W MAIN ST, CARBONDALE, IL 62901-1031
(618) 549-5361
(618) 549-5128
Mailing address
PO BOX 1105, INDIANAPOLIS, IN 46206-1105
(618) 549-5361
(618) 549-5128

Taxonomy

Speciality
Code
Description
License number
State
208600000X
Surgery Physician
Primary
36-078587
IL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
027516
HEALTH ALLIANCE
IL
05
036078587
IL
01
142410
HEALTHLINK INSURANCE
IL
01
20016640
RR MEDICARE
IL
01
324130
GHP
IL
01
3932056
BCBS OF IL
IL
01
42496
GHP
IL
01
7210895
AETNA
IL
Enumeration date
02/28/2006
Last updated
07/07/2011
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