Provider Demographics
NPI:1255385621
Name:DUTTON, TERRY G (MD)
Entity type:Individual
Prefix:DR
First Name:TERRY
Middle Name:G
Last Name:DUTTON
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:1909 E RAY RD
Mailing Address - Street 2:SUITE 9-154
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85225-8724
Mailing Address - Country:US
Mailing Address - Phone:480-888-5421
Mailing Address - Fax:855-847-8908
Practice Address - Street 1:1909 E RAY RD
Practice Address - Street 2:SUITE 9-154
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85225-8724
Practice Address - Country:US
Practice Address - Phone:480-888-5421
Practice Address - Fax:855-847-8908
Is Sole Proprietor?:Yes
Enumeration Date:2006-05-20
Last Update Date:2015-01-23
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Provider Licenses
StateLicense IDTaxonomies
AZ34290207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZI37285Medicare UPIN