Healthcare Provider Details

I. General information

NPI: 1750383204
Provider Name (Legal Business Name): ROBBY K HUTCHINSON MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/15/2005
Last Update Date: 12/11/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

117 CROSSFIELD DR SUITE B
VERSAILLES KY
40383-1982
US

IV. Provider business mailing address

117 CROSSFIELD DR SUITE B
VERSAILLES KY
40383-1982
US

V. Phone/Fax

Practice location:
  • Phone: 859-873-9188
  • Fax: 859-873-0870
Mailing address:
  • Phone: 859-873-9188
  • Fax: 859-873-0870

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number29821
License Number StateKY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: