MEDICARE: ROBERT M HUTTON 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
1	207P00000X	Emergency Medicine Physician	12717	TN

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	3110216	OTHER	TN	STONES RIVER IPA
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
3	4040144	OTHER	TN	BCBS

General Provider Information

NPI Number	:	1902836307
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ROBERT M HUTTON M.D.

Provider Business Mailing Address
First Line	:	1 VANTAGE WAY
Second Line	:	SUITE B240
City	:	NASHVILLE
State	:	TN
Zip	:	37228-1515
Country	:	US
Telephone Number	:	615-329-4020
Fax Number	:	615-327-4403

Provider Business Practice Location Address
First Line	:	2000 CHURCH STREET
Second Line	:
City	:	NASHVILLE
State	:	TN
Zip	:	37203
Country	:	US
Telephone Number	:	800-251-2014
Fax Number	:	615-284-3854

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/03/2006
Last Update Date	:	06/10/2010

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