Healthcare Provider Details

I. General information

NPI: 1073588893
Provider Name (Legal Business Name): THOMAS L HUTCHINSON M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/23/2006
Last Update Date: 02/12/2021
Certification Date: 02/12/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

11725 ILLINOIS STREET SUITE 465
CARMEL IN
46032-3010
US

IV. Provider business mailing address

250 N SHADELAND AVE
INDIANAPOLIS IN
46219-4959
US

V. Phone/Fax

Practice location:
  • Phone: 317-817-0010
  • Fax: 317-817-0012
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number01029477A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: