Provider Demographics
NPI:1679656219
Name:SCUTCHFIELD, SAMUEL APPLETON (MD)
Entity Type:Individual
Prefix:DR
First Name:SAMUEL
Middle Name:APPLETON
Last Name:SCUTCHFIELD
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 1:10800 E GEDDES AVE STE 300
Mailing Address - Street 2:
Mailing Address - City:ENGLEWOOD
Mailing Address - State:CO
Mailing Address - Zip Code:80112-3895
Mailing Address - Country:US
Mailing Address - Phone:720-493-3642
Mailing Address - Fax:720-874-4462
Practice Address - Street 1:10800 E GEDDES AVE STE 300
Practice Address - Street 2:
Practice Address - City:ENGLEWOOD
Practice Address - State:CO
Practice Address - Zip Code:80112-3895
Practice Address - Country:US
Practice Address - Phone:720-493-3642
Practice Address - Fax:720-874-4462
Is Sole Proprietor?:No
Enumeration Date:2006-10-24
Last Update Date:2024-03-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN543782085R0202X
FLTRN90972085R0202X
TXR22202085R0202X
NE257732085R0202X
KS04-367822085R0202X
HIMD175602085R0202X
CO491452085R0202X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2085R0202XAllopathic & Osteopathic PhysiciansRadiologyDiagnostic Radiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
UT1679656219Medicaid
MO1679656219Medicaid
SD1679656219Medicaid
TX1679656219Medicaid
IA1679656219Medicaid
KS200859680AMedicaid
AKMD944COMedicaid
CO66855527Medicaid
NC7617651Medicaid
SD1679656219Medicaid
UT1679656219Medicaid
NENA1215066Medicare PIN
HIH105018Medicare PIN
NENA2517039Medicare PIN
IA1679656219Medicaid
AKMD944COMedicaid
HIH105136Medicare PIN
COCOAAA0745Medicare PIN
NENA1214066Medicare PIN