Healthcare Provider Details

I. General information

NPI: 1912960980
Provider Name (Legal Business Name): THOMAS W HUTH MD
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 04/10/2006
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1911 CHESTER BLVD
RICHMOND IN
47374
US

IV. Provider business mailing address

1911 CHESTER BLVD
RICHMOND IN
47374
US

V. Phone/Fax

Practice location:
  • Phone: 765-962-0414
  • Fax: 765-966-2480
Mailing address:
  • Phone: 765-962-0414
  • Fax: 765-966-2480

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number01040082
License Number StateIN
# 2
Primary TaxonomyN
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number01047370
License Number StateIN
# 3
Primary TaxonomyY
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number71000483
License Number StateIN

VIII. Authorized Official

Name: MRS. PATRICIA ANN STOKES
Title or Position: OFFICE MANAGER
Credential:
Phone: 765-962-0414