MEDICARE: BOB HUTCHINS

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207P00000X	Emergency Medicine Physician	09818	MO
2	207R00000X	Internal Medicine Physician	09818	MS

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1033150263
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BOB HUTCHINS

Provider Business Mailing Address
First Line	:	PO BOX 746085
Second Line	:
City	:	ATLANTA
State	:	GA
Zip	:	30374-6085
Country	:	US
Telephone Number	:	469-727-6675
Fax Number	:

Provider Business Practice Location Address
First Line	:	911 ELLIS AVE
Second Line	:
City	:	JACKSON
State	:	MS
Zip	:	39209-6256
Country	:	US
Telephone Number	:	601-533-7016
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/09/2006
Last Update Date	:	11/19/2024

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Directions to “ BOB HUTCHINS ” Practice Location

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