Basic Information
Provider Information
NPI: 1417036310
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: CUTRIGHT
FirstName: CALVIN
MiddleName: W
NamePrefix: DR.
NameSuffix:  
Credential: M.D.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: 1625 DORWART DR
Address2: PO BOX 379
City: SIDNEY
State: NE
PostalCode: 691622505
CountryCode: US
TelephoneNumber: 3082545544
FaxNumber: 3082542672
Practice Location
Address1: 1625 DORWART DR
Address2:  
City: SIDNEY
State: NE
PostalCode: 691622505
CountryCode: US
TelephoneNumber: 3082545544
FaxNumber: 3082542672
Other Information
ProviderEnumerationDate: 11/03/2006
LastUpdateDate: 08/02/2007
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: M
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207Q00000X11543NEY Allopathic & Osteopathic PhysiciansFamily Medicine 

No ID Information.


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