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NPI Code Detail

MEDICARE: KELLEY A HUTCHESON M.D.

MEDICARE: KELLEY A HUTCHESON M.D.
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
1208G00000XThoracic Surgery (Cardiothoracic Vascular Surgery) PhysicianP6646TX
2208G00000XThoracic Surgery (Cardiothoracic Vascular Surgery) Physician2011015965MO

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 : 1518162650
Entity Type Code : Individual
Provider Name (Legal Business Name) : KELLEY A HUTCHESON M.D.
Provider Business Mailing Address
First Line : 5909 LUTHER LN APT 1906
Second Line :
City : DALLAS
State : TX
Zip : 75225-5913
Country : US
Telephone Number : 919-949-2661
Fax Number :
Provider Business Practice Location Address
First Line : 4716 ALLIANCE BLVD, PAVILION II
Second Line : SUITE 310
City : PLANO
State : TX
Zip : 75093-1010
Country : US
Telephone Number : 469-800-6200
Fax Number : 469-800-6210
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/19/2007
Last Update Date : 09/26/2014

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