Provider Demographics
NPI:1154309730
Name:HUTCHINSON, JUDITH (MD)
Entity type:Individual
Prefix:
First Name:JUDITH
Middle Name:
Last Name:HUTCHINSON
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4536 S BUCKSKIN WAY
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85249-5964
Mailing Address - Country:US
Mailing Address - Phone:717-321-6335
Mailing Address - Fax:
Practice Address - Street 1:4536 S BUCKSKIN WAY
Practice Address - Street 2:
Practice Address - City:CHANDLER
Practice Address - State:AZ
Practice Address - Zip Code:85249-5964
Practice Address - Country:US
Practice Address - Phone:717-321-6335
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-01-04
Last Update Date:2024-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD-056447-L207L00000X
MDD0042355207L00000X
AZ49188207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ917575Medicaid
BH2975893OtherDEA
AZZ168184Medicare PIN
F68651Medicare UPIN
AZP01431146Medicare PIN