Dutcher, Jacob R
Dutcher, Jacob R is an individual health care provider with primary practice located at 1200 Sixth Ave N , St Cloud MN 56303-2735. He recently has 2 registered licenses in different health care specialties including Allopathic & Osteopathic Physicians / Cardiovascular Disease, Allopathic & Osteopathic Physicians / Interventional Cardiology. Allopathic & Osteopathic Physicians / Interventional Cardiology is his primary health care specialty. Dutcher, Jacob R can be contacted via phone (320) 656-7020.Contact Information
Primary practice address
1200 Sixth Ave N
St Cloud MN 56303-2735
Phone: (320) 656-7020
Fax:
Website:
Health care specialties
Specialty | Code | License # | State |
---|---|---|---|
Allopathic & Osteopathic Physicians / Cardiovascular Disease | 207RC0000X | 102900 | Minnesota |
Allopathic & Osteopathic Physicians / Interventional Cardiology | 207RI0011X | 43641 | Minnesota |
Allopathic & Osteopathic Physicians / Cardiovascular Disease | 207RC0000X | 43641 | Minnesota |
Profile Details
NPI number | 1619000999 |
---|---|
LBN Legal business name | Dutcher, Jacob R |
Credentials | Doctor of Medicine (MD) |
Entity | Individual |
Sole proprietor 1 | No |
Enumeration date | Mar 14th, 2007 |
Last updated | Mar 6th, 2015 - about 9 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
State | Type | Number | Issuer |
---|---|---|---|
All States | NPI | 1619000999 | NPPES |
Minnesota | MEDICAID | NPI |
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