Provider Demographics
NPI:1306028923
Name:HUTCHINS, JOHN RANDOLPH III (DC)
Entity Type:Individual
Prefix:DR
First Name:JOHN
Middle Name:RANDOLPH
Last Name:HUTCHINS
Suffix:III
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1578
Mailing Address - Street 2:
Mailing Address - City:CEDAR CREST
Mailing Address - State:NM
Mailing Address - Zip Code:87008-1578
Mailing Address - Country:US
Mailing Address - Phone:505-281-9090
Mailing Address - Fax:505-281-9525
Practice Address - Street 1:12216 N. HWY 14
Practice Address - Street 2:
Practice Address - City:CEDAR CREST
Practice Address - State:NM
Practice Address - Zip Code:87008-1578
Practice Address - Country:US
Practice Address - Phone:505-281-9090
Practice Address - Fax:505-281-9525
Is Sole Proprietor?:No
Enumeration Date:2007-12-05
Last Update Date:2007-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NM1372111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor