Healthcare Provider Details

I. General information

NPI: 1285602714
Provider Name (Legal Business Name): HUTCHESON MEDICAL CENTER INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/10/2006
Last Update Date: 02/01/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

100 GROSS CRESCENT CIR
FORT OGLETHORPE GA
30742-3643
US

IV. Provider business mailing address

100 GROSS CRESCENT CIR
FORT OGLETHORPE GA
30742-3643
US

V. Phone/Fax

Practice location:
  • Phone: 706-858-2000
  • Fax: 706-858-2732
Mailing address:
  • Phone: 706-858-2000
  • Fax: 706-858-2732

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code314000000X
TaxonomySkilled Nursing Facility
License Number10231384
License Number StateGA

VIII. Authorized Official

Name: MR. CHARLES STEWART
Title or Position: CEO
Credential:
Phone: 706-858-2101