Healthcare Provider Details

I. General information

NPI: 1285926493
Provider Name (Legal Business Name): HUTCHINSON CLINIC, PA, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/05/2011
Last Update Date: 09/20/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1100 N MAIN ST
HUTCHINSON KS
67501-4406
US

IV. Provider business mailing address

2101 N WALDRON ST
HUTCHINSON KS
67502-1131
US

V. Phone/Fax

Practice location:
  • Phone: 620-669-2500
  • Fax: 620-694-4512
Mailing address:
  • Phone: 620-669-2500
  • Fax: 620-694-4512

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QR1300X
TaxonomyRural Health Clinic/Center
License Number
License Number StateKS

VIII. Authorized Official

Name: MICHAEL HECK
Title or Position: CEO
Credential:
Phone: 620-669-2500