Provider Demographics
NPI:1063974012
Name:SAUTTER, TODD MONTE (DPM)
Entity type:Individual
Prefix:
First Name:TODD
Middle Name:MONTE
Last Name:SAUTTER
Suffix:
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1227 NE 7TH ST STE A
Mailing Address - Street 2:
Mailing Address - City:GRANTS PASS
Mailing Address - State:OR
Mailing Address - Zip Code:97526-1430
Mailing Address - Country:US
Mailing Address - Phone:541-471-3668
Mailing Address - Fax:
Practice Address - Street 1:1227 NE 7TH ST STE A
Practice Address - Street 2:
Practice Address - City:GRANTS PASS
Practice Address - State:OR
Practice Address - Zip Code:97526-1430
Practice Address - Country:US
Practice Address - Phone:541-471-3668
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-04-01
Last Update Date:2023-08-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHTBD390200000X
ORDP209583213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program