Healthcare Provider Details

I. General information

NPI: 1306057328
Provider Name (Legal Business Name): TROY E HUTCHESON PA
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 05/24/2007
Last Update Date: 03/07/2023
Certification Date: 02/19/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2467 GOLDEN CAMP RD
AUGUSTA GA
30906-5515
US

IV. Provider business mailing address

2467 GOLDEN CAMP RD
AUGUSTA GA
30906-5515
US

V. Phone/Fax

Practice location:
  • Phone: 706-790-4440
  • Fax: 706-790-4393
Mailing address:
  • Phone: 706-790-4440
  • Fax: 706-790-4393

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363AM0700X
TaxonomyMedical Physician Assistant
License Number004831
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: