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:
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Health care specialties

SpecialtyCodeLicense #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 11 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.

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Identifiers

StateTypeNumberIssuer
All States NPI 1619000999 NPPES
Minnesota MEDICAID NPI

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