Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | ME0037859 | FL |
N | 207XS0114X | Adult Reconstructive Orthopaedic Surgeon | ME0037859 | FL |
NPI | 1386643021 |
---|---|
Provider Name | Dr. John W. Mccutchen |
First Address | Winter Park, FL 32789-4949 |
Second Address | Winter Park, FL 32789-4949 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/07/2005 |
Last Update Date | 04/02/2010 |
IDENTIFIER | TYPE / CODE | IDENTIFIER STATE |
---|---|---|
065444200 | (05) | FL |
200014788 | RAILROAD (01) | FL |
61130 | BC/BS (01) | FL |
D57114 | (02) | FL |