Provider Demographics
NPI:1285627794
Name:HUTCHINS, JAMES M (OD)
Entity type:Individual
Prefix:
First Name:JAMES
Middle Name:M
Last Name:HUTCHINS
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:105 MAIN ST W
Mailing Address - Street 2:PO BOX 307
Mailing Address - City:SLEEPY EYE
Mailing Address - State:MN
Mailing Address - Zip Code:56085-1327
Mailing Address - Country:US
Mailing Address - Phone:507-794-2126
Mailing Address - Fax:507-794-5070
Practice Address - Street 1:105 MAIN ST W
Practice Address - Street 2:
Practice Address - City:SLEEPY EYE
Practice Address - State:MN
Practice Address - Zip Code:56085-1327
Practice Address - Country:US
Practice Address - Phone:507-794-2126
Practice Address - Fax:507-794-5070
Is Sole Proprietor?:Yes
Enumeration Date:2005-08-30
Last Update Date:2007-08-24
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MN1819152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
MN705823300Medicaid
T65644Medicare UPIN
MN705823300Medicaid