Provider Demographics
NPI:1649506536
Name:CUTLER, JAMES REX (DPM)
Entity type:Individual
Prefix:DR
First Name:JAMES
Middle Name:REX
Last Name:CUTLER
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:76 E 1ST S
Mailing Address - Street 2:
Mailing Address - City:REXBURG
Mailing Address - State:ID
Mailing Address - Zip Code:83440-1936
Mailing Address - Country:US
Mailing Address - Phone:208-709-9912
Mailing Address - Fax:208-932-1453
Practice Address - Street 1:76 E 1ST S
Practice Address - Street 2:
Practice Address - City:REXBURG
Practice Address - State:ID
Practice Address - Zip Code:83440-1936
Practice Address - Country:US
Practice Address - Phone:208-709-9912
Practice Address - Fax:208-932-1453
Is Sole Proprietor?:No
Enumeration Date:2009-10-27
Last Update Date:2015-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IDP-219213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX344385502Medicaid
TXP01441324OtherRAILROAD MEDICARE
TX344385501Medicaid
ILP01441324OtherRAILROAD MEDICARE
ILF400187709Medicare PIN
TX401962YR1KMedicare PIN
TX401962ZNDEMedicare PIN