Healthcare Provider Details

I. General information

NPI: 1194861625
Provider Name (Legal Business Name): MR. CHANCE M. HUTCHENS
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/30/2007
Last Update Date: 08/17/2009
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

825 E ROBINSON ST
NORMAN OK
73071-6610
US

IV. Provider business mailing address

825 E ROBINSON ST
NORMAN OK
73071-6610
US

V. Phone/Fax

Practice location:
  • Phone: 405-364-7900
  • Fax: 405-366-6214
Mailing address:
  • Phone: 405-364-7900
  • Fax: 405-366-6214

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License Number1582
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: