Basic Information
Provider Information
NPI: 1821484783
EntityType: 1
ReplacementNPI:  
OrganizationName:  
LastName: HUTCHINSON
FirstName: ANNE
MiddleName: L
NamePrefix:  
NameSuffix:  
Credential: D.O.
OtherOrganizationName:  
OtherOrganizationType:  
OtherLastName:  
OtherFirstName:  
OtherMiddleName:  
OtherNamePrefix:  
OtherNameSuffix:  
OtherCredential:  
OtherLastNameType:  
Mailing Information
Address1: PO BOX 7068
Address2:  
City: PORTSMOUTH
State: VA
PostalCode: 237070068
CountryCode: US
TelephoneNumber: 7576863516
FaxNumber: 7576860230
Practice Location
Address1: 3060 GODWIN BLVD
Address2:  
City: SUFFOLK
State: VA
PostalCode: 234348274
CountryCode: US
TelephoneNumber: 7579355310
FaxNumber: 7579355311
Other Information
ProviderEnumerationDate: 04/07/2015
LastUpdateDate: 12/04/2018
NPIDeactivationReasonCode:  
NPIDeactivationDate:  
NPIReactivationDate:  
ProviderGenderCode: F
AuthorizedOfficialLastName:  
AuthorizedOfficialFirstName:  
AuthorizedOfficialMiddleName:  
AuthorizedOfficialTitleorPosition:  
AuthorizedOfficialTelephone:  
IsSoleProprietor: N
IsOrganizationSubpart:  
ParentOrganizationLBN:  
AuthorizedOfficialNamePrefix:  
AuthorizedOfficialNameSuffix:  
AuthorizedOfficialCredential:  
NPICertificationDate:  

Taxonomy Information
TaxonomyLicenseStateSwitchTaxonomyGroupTaxonomyTypeTaxonomyClassSubSpecialty
207Q00000X0102205324VAY Allopathic & Osteopathic PhysiciansFamily Medicine 

No ID Information.


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