Healthcare Provider Details

I. General information

NPI: 1134206816
Provider Name (Legal Business Name): ANDREW JOHN HUTCHINSON DO
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/01/2006
Last Update Date: 10/31/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

701 JEFFERSON ST
WHITEVILLE NC
28472-3704
US

IV. Provider business mailing address

711 N FRANKLIN ST
WHITEVILLE NC
28472-3412
US

V. Phone/Fax

Practice location:
  • Phone: 910-640-2051
  • Fax: 910-640-2059
Mailing address:
  • Phone: 910-640-2051
  • Fax: 910-640-2059

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number200200238
License Number StateNC
# 2
Primary TaxonomyN
Taxonomy Code2086S0129X
TaxonomyVascular Surgery Physician
License Number200200238
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: