Provider Demographics
NPI:1316050818
Name:HUTCHINSON, THOMAS A (OD)
Entity type:Individual
Prefix:MR
First Name:THOMAS
Middle Name:A
Last Name:HUTCHINSON
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:204 SOMERSET PL
Mailing Address - Street 2:
Mailing Address - City:ENTERPRISE
Mailing Address - State:AL
Mailing Address - Zip Code:36330-8142
Mailing Address - Country:US
Mailing Address - Phone:334-347-3139
Mailing Address - Fax:
Practice Address - Street 1:1537 S US HIGHWAY 231
Practice Address - Street 2:
Practice Address - City:OZARK
Practice Address - State:AL
Practice Address - Zip Code:36360-2846
Practice Address - Country:US
Practice Address - Phone:334-774-4235
Practice Address - Fax:334-774-4255
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-17
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ALS-604-TA-253152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist