Provider Demographics
NPI:1114177722
Name:HUTTO, MALACHI III (PA)
Entity Type:Individual
Prefix:
First Name:MALACHI
Middle Name:
Last Name:HUTTO
Suffix:III
Gender:M
Credentials:PA
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Mailing Address - Street 1:2300A MANCHESTER EXPRESS WAY SUITE 101A
Mailing Address - Street 2:ST. FRANCIS ORTHOPAEDIC INSTITUTE
Mailing Address - City:COLUMBUS
Mailing Address - State:GA
Mailing Address - Zip Code:31904
Mailing Address - Country:US
Mailing Address - Phone:706-322-6646
Mailing Address - Fax:706-322-2891
Practice Address - Street 1:2300A MANCHESTER EXPRESS WAY SUITE 101A
Practice Address - Street 2:ST. FRANCIS ORTHOPAEDIC INSTITUTE
Practice Address - City:COLUMBUS
Practice Address - State:GA
Practice Address - Zip Code:31904
Practice Address - Country:US
Practice Address - Phone:706-322-6646
Practice Address - Fax:706-322-2891
Is Sole Proprietor?:No
Enumeration Date:2008-09-19
Last Update Date:2009-04-21
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
GA005420363AS0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363AS0400XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician AssistantSurgical