MEDICARE: DOUGLAS T HUTCHINSON MD

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	207XS0106X	Orthopaedic Hand Surgery Physician	183461-1205	UT
2	207X00000X	Orthopaedic Surgery Physician	183461-1205	UT

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1972557825
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DOUGLAS T HUTCHINSON MD

Provider Business Mailing Address
First Line	:	PO BOX 413067
Second Line	:
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84141-3067
Country	:	US
Telephone Number	:	801-213-3900
Fax Number	:

Provider Business Practice Location Address
First Line	:	590 S WAKARA WAY
Second Line	:
City	:	SALT LAKE CITY
State	:	UT
Zip	:	84108-1200
Country	:	US
Telephone Number	:	801-587-7109
Fax Number	:

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

Provider Enumeration Date	:	05/22/2006
Last Update Date	:	10/20/2021

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