Provider Demographics
NPI:1831649524
Name:JAMES J CLOUTIER DPM, LTD
Entity Type:Organization
Organization Name:JAMES J CLOUTIER DPM, LTD
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MANAGING EMPLOYEE
Authorized Official - Prefix:DR
Authorized Official - First Name:JAMES
Authorized Official - Middle Name:J
Authorized Official - Last Name:CLOUTIER
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:401-766-4444
Mailing Address - Street 1:919 DIAMOND HILL RD
Mailing Address - Street 2:
Mailing Address - City:WOONSOCKET
Mailing Address - State:RI
Mailing Address - Zip Code:02895-1457
Mailing Address - Country:US
Mailing Address - Phone:401-766-4444
Mailing Address - Fax:
Practice Address - Street 1:919 DIAMOND HILL RD
Practice Address - Street 2:
Practice Address - City:WOONSOCKET
Practice Address - State:RI
Practice Address - Zip Code:02895-1457
Practice Address - Country:US
Practice Address - Phone:401-766-4444
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2016-10-06
Last Update Date:2016-10-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
RIDPM00270213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty