Basic Information
| Provider Information | |||||||||
| NPI: | 1609824267 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | HUTCHISON | ||||||||
| FirstName: | JEFFREY | ||||||||
| MiddleName: | D | ||||||||
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| Credential: | DO | ||||||||
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| Mailing Information | |||||||||
| Address1: | 100 W THIRD AVE | ||||||||
| Address2: | |||||||||
| City: | COLUMBIA | ||||||||
| State: | OH | ||||||||
| PostalCode: | 43201 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6142971158 | ||||||||
| FaxNumber: | 6142993406 | ||||||||
| Practice Location | |||||||||
| Address1: | 5131 BEACON HILL ROAD | ||||||||
| Address2: | |||||||||
| City: | COLUMBUS | ||||||||
| State: | OH | ||||||||
| PostalCode: | 43228 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 6148781571 | ||||||||
| FaxNumber: | 6148788330 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/05/2006 | ||||||||
| LastUpdateDate: | 07/08/2007 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | X | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 2086S0102X | 34004318 | OH | Y | Allopathic & Osteopathic Physicians | Surgery | Surgical Critical Care |
ID Information
| ID | Type | State | Issuer | Description | 0752430 | 05 | OH | MEDICAID |