Healthcare Provider Details

I. General information

NPI: 1134503600
Provider Name (Legal Business Name): ROBERT HUTCHCRAFT
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 07/15/2015
Last Update Date: 07/15/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

441 S INDEPENDENCE BLVD
VIRGINIA BEACH VA
23452-1126
US

IV. Provider business mailing address

441 S INDEPENDENCE BLVD
VIRGINIA BEACH VA
23452-1126
US

V. Phone/Fax

Practice location:
  • Phone: 888-333-5744
  • Fax:
Mailing address:
  • Phone: 888-333-5744
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code237700000X
TaxonomyHearing Instrument Specialist
License Number2101001588
License Number StateVA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: