Healthcare Provider Details
I. General information
NPI: 1396793923
Provider Name (Legal Business Name): LISA H HUTCHISON M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N
II. Dates (important events)
Enumeration Date: 05/05/2006
Last Update Date: 10/31/2019
Certification Date:
Deactivation Date:
Reactivation Date:
III. Provider practice location address
10500 QUIVIRA RD
OVERLAND PARK KS
66215-2373
US
IV. Provider business mailing address
10310 N GARFIELD AVE
KANSAS CITY MO
64155-3244
US
V. Phone/Fax
- Phone: 816-679-8710
- Fax:
- Phone: 816-679-8710
- Fax:
VI. Provider taxonomy
Scope of Practice (Provider specialty)
| # 1 | |
| Primary Taxonomy | Y |
| Taxonomy Code | 2085P0229X |
| Taxonomy | Pediatric Radiology Physician |
| License Number | 2000171363 |
| License Number State | MO |
VIII. Authorized Official
Name:
Title or Position:
Credential:
Phone: