Healthcare Provider Details

I. General information

NPI: 1295926830
Provider Name (Legal Business Name): GINA G HUTTON M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: GINA D GLENN M.D.

II. Dates (important events)

Enumeration Date: 08/08/2007
Last Update Date: 10/01/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

444 N MAIN ST FL 6
AKRON OH
44310-3110
US

IV. Provider business mailing address

3445 S MAIN ST
COVENTRY TOWNSHIP OH
44319-3028
US

V. Phone/Fax

Practice location:
  • Phone: 330-379-8190
  • Fax: 330-379-8191
Mailing address:
  • Phone: 330-644-4095
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code2084P0800X
TaxonomyPsychiatry Physician
License Number35089150
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: