Provider Demographics
NPI:1912104035
Name:DR. JEFFREY C. HUTCHINS
Entity type:Organization
Organization Name:DR. JEFFREY C. HUTCHINS
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BILLING CLERK
Authorized Official - Prefix:MRS
Authorized Official - First Name:MARY
Authorized Official - Middle Name:
Authorized Official - Last Name:MILLER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:254-445-4900
Mailing Address - Street 1:305 N PATRICK ST
Mailing Address - Street 2:
Mailing Address - City:DUBLIN
Mailing Address - State:TX
Mailing Address - Zip Code:76446-1918
Mailing Address - Country:US
Mailing Address - Phone:254-445-4900
Mailing Address - Fax:254-445-4693
Practice Address - Street 1:305 N PATRICK ST
Practice Address - Street 2:
Practice Address - City:DUBLIN
Practice Address - State:TX
Practice Address - Zip Code:76446-1918
Practice Address - Country:US
Practice Address - Phone:254-445-4900
Practice Address - Fax:254-445-4693
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-07-02
Last Update Date:2008-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXK4088207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX145632903Medicaid