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NPI Code Detail

MEDICARE: JEREMY BRIAN HUTSON PA-C

MEDICARE: JEREMY BRIAN HUTSON PA-C
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
1363AM0700XMedical Physician AssistantTX

General Provider Information

NPI Number : 1700173275
Entity Type Code : Individual
Provider Name (Legal Business Name) : JEREMY BRIAN HUTSON PA-C
Provider Business Mailing Address
First Line : 4301 WILSON ST
Second Line :
City : LAWTON
State : OK
Zip : 73503-4472
Country : US
Telephone Number : 580-422-5566
Fax Number : 580-422-7131
Provider Business Practice Location Address
First Line : 4301 WILSON ST
Second Line :
City : LAWTON
State : OK
Zip : 73503-4472
Country : US
Telephone Number : 580-422-5566
Fax Number : 580-422-7131
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 07/06/2011
Last Update Date : 02/07/2025

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Directions to “ JEREMY BRIAN HUTSON PA-C” Practice Location

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