Healthcare Provider Details

I. General information

NPI: 1235876863
Provider Name (Legal Business Name): EMILY REBECCA HUTCHINSON DO
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 05/16/2022
Last Update Date: 11/18/2025
Certification Date: 11/18/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

20 PROGRESS POINT PKWY STE 108
O FALLON MO
63368-2207
US

IV. Provider business mailing address

PO BOX 959354
SAINT LOUIS MO
63195-9354
US

V. Phone/Fax

Practice location:
  • Phone: 636-344-2400
  • Fax: 636-344-2401
Mailing address:
  • Phone: 636-344-2400
  • Fax: 636-344-2401

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number2025024066
License Number StateMO
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number2022021160
License Number StateMO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: