Healthcare Provider Details

I. General information

NPI: 1093740367
Provider Name (Legal Business Name): RICKEY LADON HUTCHESON D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/12/2006
Last Update Date: 10/02/2025
Certification Date: 10/02/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2350 NORTH OCOEE STREET
CLEVELAND TN
37311
US

IV. Provider business mailing address

2350 N OCOEE ST
CLEVELAND TN
37311-3850
US

V. Phone/Fax

Practice location:
  • Phone: 423-476-5554
  • Fax: 423-614-6116
Mailing address:
  • Phone: 423-476-5554
  • Fax: 423-614-6116

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207X00000X
TaxonomyOrthopaedic Surgery Physician
License NumberDO1134
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: