=====================================================
General NPI Number Information
=====================================================
NPI Number | 1912054974
-----------------------------------------------------
Entity Type | Organization
-----------------------------------------------------
Legal Business Name | ANDREW J HUTCHINSON DO PA
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 01/04/2007
-----------------------------------------------------
Last Update Date | 02/14/2022
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 711 N FRANKLIN ST
-----------------------------------------------------
City | WHITEVILLE
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 28472-3412
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 910-640-2051
-----------------------------------------------------
Fax | 910-640-2059
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 711 N FRANKLIN ST
-----------------------------------------------------
City | WHITEVILLE
-----------------------------------------------------
State | NC
-----------------------------------------------------
Zip | 28472-3412
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 910-640-2051
-----------------------------------------------------
Fax | 910-640-2059
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position | PRESIDENT
-----------------------------------------------------
Name | DR. ANDREW J HUTCHINSON
-----------------------------------------------------
Credential | DO
-----------------------------------------------------
Telephone | 910-640-2051
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 2086S0129X
-----------------------------------------------------
Taxonomy Name | Vascular Surgery Physician
-----------------------------------------------------
License Number | 2002-00238
-----------------------------------------------------
License Number State | NC
-----------------------------------------------------