Provider Demographics
NPI:1346293461
Name:HUTCHINSON, CLINTON T (MD)
Entity type:Individual
Prefix:DR
First Name:CLINTON
Middle Name:T
Last Name:HUTCHINSON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:9500 KANIS RD
Mailing Address - Street 2:STE 200
Mailing Address - City:LITTLE ROCK
Mailing Address - State:AR
Mailing Address - Zip Code:72205-6324
Mailing Address - Country:US
Mailing Address - Phone:501-224-6699
Mailing Address - Fax:501-224-7752
Practice Address - Street 1:9500 KANIS RD
Practice Address - Street 2:STE 200
Practice Address - City:LITTLE ROCK
Practice Address - State:AR
Practice Address - Zip Code:72205-6324
Practice Address - Country:US
Practice Address - Phone:501-224-6699
Practice Address - Fax:501-224-7752
Is Sole Proprietor?:No
Enumeration Date:2006-05-18
Last Update Date:2008-05-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
ARE-4923207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR164165001Medicaid
AR710619986OtherCIGNA
AR06100013100OtherQUALCHOICE
AR7678851OtherAETNA
AR2540378OtherUNITED HEALTHCARE
AR5N603OtherBCBS
AR710619986OtherCIGNA
AR164165001Medicaid