Provider Demographics
NPI:1912566126
Name:CUTCHALL, JAMES LEE
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:LEE
Last Name:CUTCHALL
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 1:717 OAK CREEK DR
Mailing Address - Street 2:
Mailing Address - City:MOORE
Mailing Address - State:OK
Mailing Address - Zip Code:73160-0909
Mailing Address - Country:US
Mailing Address - Phone:405-694-9049
Mailing Address - Fax:
Practice Address - Street 1:717 OAK CREEK DR
Practice Address - Street 2:
Practice Address - City:MOORE
Practice Address - State:OK
Practice Address - Zip Code:73160-0909
Practice Address - Country:US
Practice Address - Phone:405-694-9049
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-11
Last Update Date:2019-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator