Healthcare Provider Details

I. General information

NPI: 1073604377
Provider Name (Legal Business Name): JEFFREY THOMAS HUTCHINSON M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/28/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1601 PERDIDO ST
NEW ORLEANS LA
70112-1262
US

IV. Provider business mailing address

PO BOX 55087
METAIRIE LA
70055-5087
US

V. Phone/Fax

Practice location:
  • Phone: 504-589-5988
  • Fax: 504-556-7235
Mailing address:
  • Phone: 504-606-5983
  • Fax: 504-556-7235

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License Number014166
License Number StateLA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: