Provider Demographics
NPI:1275560815
Name:CUTTING, JON A (MD)
Entity Type:Individual
Prefix:
First Name:JON
Middle Name:A
Last Name:CUTTING
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:980 W. IRONWOOD
Mailing Address - Street 2:SUITE 101
Mailing Address - City:COEUR D'ALENE
Mailing Address - State:ID
Mailing Address - Zip Code:83814
Mailing Address - Country:US
Mailing Address - Phone:208-765-1455
Mailing Address - Fax:208-667-8655
Practice Address - Street 1:980 W. IRONWOOD
Practice Address - Street 2:SUITE 101
Practice Address - City:COEUR D'ALENE
Practice Address - State:ID
Practice Address - Zip Code:83814
Practice Address - Country:US
Practice Address - Phone:208-765-1455
Practice Address - Fax:208-667-8655
Is Sole Proprietor?:No
Enumeration Date:2006-06-27
Last Update Date:2010-07-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDM-3368207V00000X
IDM3368207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
ID002588400Medicaid
ID002588400Medicaid
ID1110589Medicare ID - Type Unspecified