Healthcare Provider Details

I. General information

NPI: 1760687990
Provider Name (Legal Business Name): BRETT ANDREW HUTCHINSON M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/18/2007
Last Update Date: 10/17/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

12525 PERKINS RD SUITE C
BATON ROUGE LA
70810-1907
US

IV. Provider business mailing address

12525 PERKINS RD SUITE C
BATON ROUGE LA
70810-1907
US

V. Phone/Fax

Practice location:
  • Phone: 225-769-2003
  • Fax: 225-767-3055
Mailing address:
  • Phone: 225-769-2003
  • Fax: 225-767-3055

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number200286
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: