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NPI Code Detail

MEDICARE: DR. MARK CRATON HUTTO MD

MEDICARE: DR. MARK CRATON HUTTO MD
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
12084P0800XPsychiatry Physician21010GA

General Provider Information

NPI Number : 1699844159
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. MARK CRATON HUTTO MD
Provider Business Mailing Address
First Line : 2150 PEACHFORD ROAD
Second Line : SUITE R
City : ATLANTA
State : GA
Zip : 30338-6534
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 2150 PEACHFORD ROAD
Second Line : SUITE R
City : ATLANTA
State : GA
Zip : 30338-6534
Country : US
Telephone Number : 770-455-0261
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/07/2006
Last Update Date : 07/08/2007

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