Provider Demographics
NPI:1174841746
Name:ROBERT W HUTCHISON, DPM, LLC
Entity Type:Organization
Organization Name:ROBERT W HUTCHISON, DPM, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:W
Authorized Official - Last Name:HUTCHISON
Authorized Official - Suffix:
Authorized Official - Credentials:DPM
Authorized Official - Phone:908-688-9100
Mailing Address - Street 1:1095 MORRIS AVE STE 103
Mailing Address - Street 2:
Mailing Address - City:UNION
Mailing Address - State:NJ
Mailing Address - Zip Code:07083-7143
Mailing Address - Country:US
Mailing Address - Phone:908-688-9100
Mailing Address - Fax:908-688-9101
Practice Address - Street 1:1095 MORRIS AVE STE 103
Practice Address - Street 2:
Practice Address - City:UNION
Practice Address - State:NJ
Practice Address - Zip Code:07083-7143
Practice Address - Country:US
Practice Address - Phone:908-688-9100
Practice Address - Fax:908-688-9101
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2010-05-06
Last Update Date:2019-11-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ25MD00257000213E00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes213E00000XPodiatric Medicine & Surgery Service ProvidersPodiatristGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ6402530001Medicare NSC
183689Medicare PIN