Healthcare Provider Details

I. General information

NPI: 1134231756
Provider Name (Legal Business Name): HEATHER MCCOY HUTCHINGS DO
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/31/2006
Last Update Date: 02/19/2024
Certification Date: 09/06/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

460 MEDICAL PARK DR STE 108B
LENOIR CITY TN
37772-5782
US

IV. Provider business mailing address

460 MEDICAL PARK DR STE 108B
LENOIR CITY TN
37772-5782
US

V. Phone/Fax

Practice location:
  • Phone: 865-562-3232
  • Fax: 865-218-7526
Mailing address:
  • Phone: 865-562-3232
  • Fax: 865-218-7526

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number843
License Number StateSC
# 2
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberDO2617
License Number StateTN
# 3
Primary TaxonomyY
Taxonomy Code207R00000X
TaxonomyInternal Medicine Physician
License Number2617
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: