Healthcare Provider Details

I. General information

NPI: 1447783717
Provider Name (Legal Business Name): MARSHALL HUTCHISON D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/04/2017
Last Update Date: 09/22/2026
Certification Date: 09/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6051 U S HIGHWAY 49
HATTIESBURG MS
39401-7200
US

IV. Provider business mailing address

PO BOX 3488 DEPT# 05-151
TUPELO MS
38803-3488
US

V. Phone/Fax

Practice location:
  • Phone: 601-288-7000
  • Fax: 706-596-6704
Mailing address:
  • Phone: 866-264-3435
  • Fax: 706-596-6704

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code2085R0202X
TaxonomyDiagnostic Radiology Physician
License NumberW2862
License Number StateTX
# 2
Primary TaxonomyY
Taxonomy Code2085R0204X
TaxonomyVascular & Interventional Radiology Physician
License Number31375
License Number StateMS
# 3
Primary TaxonomyN
Taxonomy Code2085R0204X
TaxonomyVascular & Interventional Radiology Physician
License NumberW2862
License Number StateTX

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: