Provider Demographics
NPI:1114941358
Name:CUTLER, JEFFREY LYLE
Entity Type:Individual
Prefix:
First Name:JEFFREY
Middle Name:LYLE
Last Name:CUTLER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:JEFFREY
Other - Middle Name:LYLE
Other - Last Name:CUTLER
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:MD
Mailing Address - Street 1:PO BOX 172263
Mailing Address - Street 2:
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80217-2263
Mailing Address - Country:US
Mailing Address - Phone:303-306-7783
Mailing Address - Fax:303-306-7753
Practice Address - Street 1:850 E HARVARD AVE STE 505
Practice Address - Street 2:
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80210-5078
Practice Address - Country:US
Practice Address - Phone:303-744-1961
Practice Address - Fax:303-744-1154
Is Sole Proprietor?:No
Enumeration Date:2006-07-27
Last Update Date:2024-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MDD0066831207Y00000X
CODR.0048532207Y00000X
CO48532207YX0602X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207YX0602XAllopathic & Osteopathic PhysiciansOtolaryngologyOtolaryngic Allergy
No207Y00000XAllopathic & Osteopathic PhysiciansOtolaryngology
Provider Identifiers
StateIdentifier IDID TypeIssuer
MD415096100Medicaid
DC136054YLUMedicare PIN
TNI29059Medicare UPIN
CO48532Medicare PIN
TN3327728Medicare ID - Type UnspecifiedMEDICARE