Healthcare Provider Details

I. General information

NPI: 1477756542
Provider Name (Legal Business Name): JAMES RUSSELL HUTCHERSON NP-C
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/07/2007
Last Update Date: 08/05/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2017 OBRIG AVE
GUNTERSVILLE AL
35976-2156
US

IV. Provider business mailing address

2017 OBRIG AVE
GUNTERSVILLE AL
35976-2156
US

V. Phone/Fax

Practice location:
  • Phone: 256-582-2324
  • Fax: 256-582-2321
Mailing address:
  • Phone: 256-582-2324
  • Fax: 256-582-2321

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number1-102665
License Number StateAL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: