Provider Demographics
NPI:1295852119
Name:DUTTON, JAMES R
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:R
Last Name:DUTTON
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1960 FERRIS RD
Mailing Address - Street 2:
Mailing Address - City:COLUMBUS
Mailing Address - State:OH
Mailing Address - Zip Code:43224-2249
Mailing Address - Country:US
Mailing Address - Phone:614-204-0860
Mailing Address - Fax:
Practice Address - Street 1:1960 FERRIS RD
Practice Address - Street 2:
Practice Address - City:COLUMBUS
Practice Address - State:OH
Practice Address - Zip Code:43224-2249
Practice Address - Country:US
Practice Address - Phone:614-204-0860
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes372600000XNursing Service Related ProvidersAdult Companion
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2530103OtherFCBMRDD
OH2631076OtherCARESTAR