MEDICARE: JAY HUTSELL

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	237700000X	Hearing Instrument Specialist	HAS-T-10126936	OR

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	:	1649429614
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JAY HUTSELL

Provider Business Mailing Address
First Line	:	413 S CENTRAL VALLEY DR
Second Line	:
City	:	CENTRAL POINT
State	:	OR
Zip	:	97502-1511
Country	:	US
Telephone Number	:	541-899-9194
Fax Number	:	541-899-1519

Provider Business Practice Location Address
First Line	:	675 N 5TH ST STE A
Second Line	:
City	:	JACKSONVILLE
State	:	OR
Zip	:	97530-9659
Country	:	US
Telephone Number	:	541-899-9194
Fax Number	:	541-899-1519

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

Provider Enumeration Date	:	09/15/2008
Last Update Date	:	09/15/2008

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Directions to “ JAY HUTSELL ” Practice Location

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