Provider Demographics
NPI:1043298474
Name:HUTCHINSON CLINIC, P.A., INC.
Entity type:Organization
Organization Name:HUTCHINSON CLINIC, P.A., INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:MR
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:HECK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:620-669-2500
Mailing Address - Street 1:2101 N WALDRON ST
Mailing Address - Street 2:
Mailing Address - City:HUTCHINSON
Mailing Address - State:KS
Mailing Address - Zip Code:67502-1131
Mailing Address - Country:US
Mailing Address - Phone:620-669-2500
Mailing Address - Fax:620-669-2598
Practice Address - Street 1:2101 N WALDRON ST
Practice Address - Street 2:
Practice Address - City:HUTCHINSON
Practice Address - State:KS
Practice Address - Zip Code:67502-1131
Practice Address - Country:US
Practice Address - Phone:620-669-2500
Practice Address - Fax:620-669-2598
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-01-05
Last Update Date:2016-09-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal MedicineGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100087920 AMedicaid
CS7923OtherPALMETTO MEDICARE
KS207R00000XOtherTAXONOMY CODE
CS7923OtherPALMETTO MEDICARE