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NPI Code Detail

MEDICARE: BOB HUTCHINSON PA

MEDICARE: BOB HUTCHINSON PA
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
1111N00000XChiropractorCH2675FL

Other Identifiers

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

General Provider Information

NPI Number : 1235460619
Entity Type Code : Organization
Provider Name (Legal Business Name) : BOB HUTCHINSON PA
Provider Business Mailing Address
First Line : 1413 KINGSLEY AVE
Second Line :
City : ORANGE PARK
State : FL
Zip : 32073-4527
Country : US
Telephone Number : 904-264-9366
Fax Number : 904-278-7171
Provider Business Practice Location Address
First Line : 1413 KINGSLEY AVE
Second Line :
City : ORANGE PARK
State : FL
Zip : 32073-4527
Country : US
Telephone Number : 904-264-9366
Fax Number : 904-278-7171
Authorized Official
Title or Position : PRESIDENT/OWNER
Name : MR. BOBBY LEE HUTCHINSON
Credential : D.C.
Telephone Number : 904-264-3966
Provider Enumeration Date : 01/25/2010
Last Update Date : 02/04/2011

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Directions to “BOB HUTCHINSON PA ” Practice Location

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