| David L Dutra Dpm Inc | |
|
613 New York Ranch Rd, Jackson, CA 95642-9328 | |
| (209) 223-3030 | |
| (209) 223-5864 |
| Full Name | David L Dutra Dpm Inc |
|---|---|
| Type | Facility |
| Speciality | Podiatrist |
| Location | 613 New York Ranch Rd, Jackson, California |
| Accepts Medicare Assignments | Medicare enrolled and accepts medicare insurance. Providers at this facility may prescribe medicare part D drugs. |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1043339328 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 213E00000X | Podiatrist | E3190 (California) | Primary |
| Provider Name | David Dutra |
|---|---|
| Provider Type | Practitioner - Podiatry |
| Provider Identifiers | NPI Number: 1700989118 PECOS PAC ID: 2860388543 Enrollment ID: I20041203000915 |
| Mailing Address | Practice Location Address |
|---|---|
| David L Dutra Dpm Inc Po Box 938, Jackson, CA 95642-0938 Ph: (209) 223-3030 | David L Dutra Dpm Inc 613 New York Ranch Rd, Jackson, CA 95642-9328 Ph: (209) 223-3030 |
Dr. Alton J. Smalley, D.P.M. Podiatrist Medicare: May Accept Medicare Assignments Practice Location: 12140 New York Ranch Road, Jackson Rancheria Health Complex, Jackson, CA 95642 Phone: 209-257-2400 Fax: 209-257-2403 | |
David Lee Dutra, DPM Podiatrist Medicare: May Accept Medicare Assignments Practice Location: 613 New York Ranch Rd, Jackson, CA 95642 Phone: 209-223-3030 Fax: 209-223-5864 | |
Dr. Kirmanj Tahsin Atrushi, D.P.M. Podiatrist Medicare: Accepting Medicare Assignments Practice Location: 12150 New York Ranch Rd, Jackson, CA 95642 Phone: 209-257-2400 Fax: 209-257-2403 |