Healthcare Provider Details

I. General information

NPI: 1750544185
Provider Name (Legal Business Name): STEPHANIE L HUTCHISON MD
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/07/2008
Last Update Date: 12/09/2024
Certification Date: 12/09/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2004 CUMBERLAND AVE STE 100
MIDDLESBORO KY
40965-1385
US

IV. Provider business mailing address

102 PINE HILL RD
MANCHESTER KY
40962-6658
US

V. Phone/Fax

Practice location:
  • Phone: 606-248-3015
  • Fax: 606-248-3024
Mailing address:
  • Phone: 830-258-6237
  • Fax: 830-895-7757

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License NumberP9371
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: