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NPI Code Detail

MEDICARE: DR. TIMOTHY PAUL HUTTON MD

MEDICARE: DR. TIMOTHY PAUL HUTTON 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
12083P0011XUndersea and Hyperbaric Medicine (Preventive Medicine) Physician86647GA
2390200000XStudent in an Organized Health Care Education/Training Program
3207Q00000XFamily Medicine Physician86647GA

General Provider Information

NPI Number : 1700315215
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. TIMOTHY PAUL HUTTON MD
Provider Business Mailing Address
First Line : 250 CHASTAIN RD NW STE 210
Second Line :
City : KENNESAW
State : GA
Zip : 30144-3214
Country : US
Telephone Number : 770-422-0517
Fax Number : 678-638-7015
Provider Business Practice Location Address
First Line : 5887 GLENRIDGE DR STE 375
Second Line :
City : SANDY SPRINGS
State : GA
Zip : 30328-6191
Country : US
Telephone Number : 678-229-2800
Fax Number : 404-845-9989
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 06/08/2017
Last Update Date : 03/23/2026

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Directions to “ DR. TIMOTHY PAUL HUTTON MD” Practice Location

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