Healthcare Provider Details

I. General information

NPI: 1275642449
Provider Name (Legal Business Name): ROBERT W HUTCHISON DPM
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/30/2006
Last Update Date: 04/26/2024
Certification Date: 04/26/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1111 12TH ST STE 211
KEY WEST FL
33040-3001
US

IV. Provider business mailing address

1111 12TH ST STE 211
KEY WEST FL
33040-3001
US

V. Phone/Fax

Practice location:
  • Phone: 305-396-3360
  • Fax: 305-396-3361
Mailing address:
  • Phone: 305-396-3360
  • Fax: 305-396-3361

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code213E00000X
TaxonomyPodiatrist
License Number25MD00257000
License Number StateNJ
# 2
Primary TaxonomyN
Taxonomy Code213E00000X
TaxonomyPodiatrist
License NumberN006069
License Number StateNY
# 3
Primary TaxonomyY
Taxonomy Code213E00000X
TaxonomyPodiatrist
License NumberPO4474
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: