Provider Demographics
NPI:1205216454
Name:HUTCHISON, FRED D (BC-HIS)
Entity Type:Individual
Prefix:
First Name:FRED
Middle Name:D
Last Name:HUTCHISON
Suffix:
Gender:M
Credentials:BC-HIS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1417 W BADDOUR PKWY
Mailing Address - Street 2:SUITE A
Mailing Address - City:LEBANON
Mailing Address - State:TN
Mailing Address - Zip Code:37087-3064
Mailing Address - Country:US
Mailing Address - Phone:615-444-5425
Mailing Address - Fax:615-444-2351
Practice Address - Street 1:1417 W BADDOUR PKWY
Practice Address - Street 2:SUITE A
Practice Address - City:LEBANON
Practice Address - State:TN
Practice Address - Zip Code:37087-3064
Practice Address - Country:US
Practice Address - Phone:615-444-5425
Practice Address - Fax:615-444-2351
Is Sole Proprietor?:No
Enumeration Date:2015-06-03
Last Update Date:2021-06-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TN226237700000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes237700000XSpeech, Language and Hearing Service ProvidersHearing Instrument Specialist