Healthcare Provider Details

I. General information

NPI: 1629000617
Provider Name (Legal Business Name): JOHN ALLEN HUTCHCROFT APN
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/07/2006
Last Update Date: 09/25/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

705 PHILLIPS PL
HUNTSVILLE AR
72740
US

IV. Provider business mailing address

PO BOX 6220
SPRINGDALE AR
72766-6220
US

V. Phone/Fax

Practice location:
  • Phone: 479-927-3100
  • Fax:
Mailing address:
  • Phone: 479-738-1700
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License NumberA01570
License Number StateAR

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: