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NPI Code Detail

MEDICARE: DR. MARY LEE HUTCHESON M.D.

MEDICARE:  DR. MARY LEE HUTCHESON  M.D.
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
12084P0800XPsychiatry PhysicianME0047996FL

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
130928OTHERFLBCBS

General Provider Information

NPI Number : 1811992456
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MARY LEE HUTCHESON M.D.
Provider Business Mailing Address
First Line : 2529 W BUSCH BLVD
Second Line : STE 800
City : TAMPA
State : FL
Zip : 33618-4524
Country : US
Telephone Number : 813-935-6060
Fax Number : 813-933-8096
Provider Business Practice Location Address
First Line : 2529 W BUSCH BLVD
Second Line : STE 800
City : TAMPA
State : FL
Zip : 33618-4524
Country : US
Telephone Number : 813-935-6060
Fax Number : 813-933-8096
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/20/2005
Last Update Date : 05/17/2022

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