Provider Demographics
NPI:1285926493
Name:HUTCHINSON CLINIC, PA, INC.
Entity type:Organization
Organization Name:HUTCHINSON CLINIC, PA, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:HECK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:620-669-2500
Mailing Address - Street 1:2101 N WALDRON ST
Mailing Address - Street 2:
Mailing Address - City:HUTCHINSON
Mailing Address - State:KS
Mailing Address - Zip Code:67502-1131
Mailing Address - Country:US
Mailing Address - Phone:620-669-2500
Mailing Address - Fax:620-694-4512
Practice Address - Street 1:1100 N MAIN ST
Practice Address - Street 2:
Practice Address - City:HUTCHINSON
Practice Address - State:KS
Practice Address - Zip Code:67501-4406
Practice Address - Country:US
Practice Address - Phone:620-669-2500
Practice Address - Fax:620-694-4512
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2011-05-05
Last Update Date:2016-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS261QR1300X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QR1300XAmbulatory Health Care FacilitiesClinic/CenterRural Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS173882Medicare Oscar/Certification