Healthcare Provider Details

I. General information

NPI: 1134194814
Provider Name (Legal Business Name): HUTCHINSON CLINIC, P.A., INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/17/2006
Last Update Date: 03/29/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1221 W NOBLE ST
LYONS KS
67554-3026
US

IV. Provider business mailing address

1221 W NOBLE ST
LYONS KS
67554-3026
US

V. Phone/Fax

Practice location:
  • Phone: 620-257-5124
  • Fax:
Mailing address:
  • Phone: 620-257-5124
  • Fax:

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 W HARMS
Title or Position: CFO
Credential:
Phone: 620-669-2500