Provider Demographics
NPI:1154496560
Name:HUTTO, JOHN OXFORD SR (MD)
Entity Type:Individual
Prefix:
First Name:JOHN
Middle Name:OXFORD
Last Name:HUTTO
Suffix:SR
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2664 ST MATTHEWS ROAD
Mailing Address - Street 2:
Mailing Address - City:ORANGEBURG
Mailing Address - State:SC
Mailing Address - Zip Code:29118-1344
Mailing Address - Country:US
Mailing Address - Phone:803-531-6689
Mailing Address - Fax:803-516-9991
Practice Address - Street 1:2664 ST MATTHEWS ROAD
Practice Address - Street 2:
Practice Address - City:ORANGEBURG
Practice Address - State:SC
Practice Address - Zip Code:29118-1344
Practice Address - Country:US
Practice Address - Phone:803-531-6689
Practice Address - Fax:803-516-9991
Is Sole Proprietor?:No
Enumeration Date:2006-11-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC12351207RC0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RC0000XAllopathic & Osteopathic PhysiciansInternal MedicineCardiovascular Disease
Provider Identifiers
StateIdentifier IDID TypeIssuer
E34098Medicare UPIN