Basic Information
| Provider Information | |||||||||
| NPI: | 1962441436 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | HUTCHISON | ||||||||
| FirstName: | DARRELL | ||||||||
| MiddleName: | L | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD | ||||||||
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| Mailing Information | |||||||||
| Address1: | PO BOX 83 | ||||||||
| Address2: | |||||||||
| City: | CORNING | ||||||||
| State: | AR | ||||||||
| PostalCode: | 724220083 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8708573399 | ||||||||
| FaxNumber: | 8708573301 | ||||||||
| Practice Location | |||||||||
| Address1: | 1300 CREASON RD | ||||||||
| Address2: | |||||||||
| City: | CORNING | ||||||||
| State: | AR | ||||||||
| PostalCode: | 724221716 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 8708573399 | ||||||||
| FaxNumber: | 8708573301 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/06/2006 | ||||||||
| LastUpdateDate: | 12/15/2020 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
| IsOrganizationSubpart: | |||||||||
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| NPICertificationDate: | 12/15/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207Q00000X | R-4659 | AR | Y | Allopathic & Osteopathic Physicians | Family Medicine | 208D00000X | R-4659 | AR | N | Allopathic & Osteopathic Physicians | General Practice |
ID Information
| ID | Type | State | Issuer | Description | 143550001 | 05 | AR | MEDICAID | 205313406 | 05 | MO | MEDICAID |