Healthcare Provider Details

I. General information

NPI: 1689703829
Provider Name (Legal Business Name): JEFFREY CHARLES HUTCHINGS MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/05/2007
Last Update Date: 01/13/2021
Certification Date: 01/13/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9101 MONROE RD SUITE 155
CHARLOTTE NC
28270-2442
US

IV. Provider business mailing address

PO BOX 60447
CHARLOTTE NC
28260-0447
US

V. Phone/Fax

Practice location:
  • Phone: 704-384-1260
  • Fax: 704-384-1289
Mailing address:
  • Phone: 704-384-1260
  • Fax: 704-384-1289

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number48518
License Number StateKY
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number200800475
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: