Provider Demographics
NPI:1427054634
Name:HUTCHINSON, DAVID BLAINE (MD)
Entity type:Individual
Prefix:DR
First Name:DAVID
Middle Name:BLAINE
Last Name:HUTCHINSON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1111 MEDICAL CENTER BLVD
Mailing Address - Street 2:STE 311N
Mailing Address - City:MARRERO
Mailing Address - State:LA
Mailing Address - Zip Code:70072-3154
Mailing Address - Country:US
Mailing Address - Phone:504-349-6131
Mailing Address - Fax:504-349-6133
Practice Address - Street 1:2955 BROWNWOOD BLVD STE 403
Practice Address - Street 2:
Practice Address - City:THE VILLAGES
Practice Address - State:FL
Practice Address - Zip Code:32163-2040
Practice Address - Country:US
Practice Address - Phone:352-674-8700
Practice Address - Fax:352-674-8714
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-22
Last Update Date:2024-06-20
Deactivation Date:2006-03-15
Deactivation Code:
Reactivation Date:2006-03-29
Provider Licenses
StateLicense IDTaxonomies
FLME169114207RC0000X
LA10382R174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
No174400000XOther Service ProvidersSpecialist
Provider Identifiers
StateIdentifier IDID TypeIssuer
LA1995771Medicaid
LAE70089Medicare UPIN
LA1995771Medicaid