Provider Demographics
NPI:1891701348
Name:TUTEN, JOHN DAVID (MD)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:DAVID
Last Name:TUTEN
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3909 MCFARLAND BLVD
Mailing Address - Street 2:
Mailing Address - City:NORTHPORT
Mailing Address - State:AL
Mailing Address - Zip Code:35476-2838
Mailing Address - Country:US
Mailing Address - Phone:205-330-1707
Mailing Address - Fax:205-333-0782
Practice Address - Street 1:3909 MCFARLAND BLVD
Practice Address - Street 2:
Practice Address - City:NORTHPORT
Practice Address - State:AL
Practice Address - Zip Code:35476-2838
Practice Address - Country:US
Practice Address - Phone:205-330-1707
Practice Address - Fax:205-333-0782
Is Sole Proprietor?:No
Enumeration Date:2006-08-01
Last Update Date:2020-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALMD.15351207Q00000X
AL15351207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
ALE45735Medicare UPIN