Provider Demographics
NPI:1477756542
Name:HUTCHERSON, JAMES RUSSELL (NP-C)
Entity Type:Individual
Prefix:MR
First Name:JAMES
Middle Name:RUSSELL
Last Name:HUTCHERSON
Suffix:
Gender:M
Credentials:NP-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2017 OBRIG AVE
Mailing Address - Street 2:
Mailing Address - City:GUNTERSVILLE
Mailing Address - State:AL
Mailing Address - Zip Code:35976-2156
Mailing Address - Country:US
Mailing Address - Phone:256-582-2324
Mailing Address - Fax:256-582-2321
Practice Address - Street 1:2017 OBRIG AVE
Practice Address - Street 2:
Practice Address - City:GUNTERSVILLE
Practice Address - State:AL
Practice Address - Zip Code:35976-2156
Practice Address - Country:US
Practice Address - Phone:256-582-2324
Practice Address - Fax:256-582-2321
Is Sole Proprietor?:No
Enumeration Date:2007-06-07
Last Update Date:2014-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AL1-102665363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
AL630303047Medicaid
AL51545031OtherBLUE CROSS BLUE SHIELD
AL51545027OtherBLUE CROSS BLUE SHIELD
AL51545028OtherBLUE CROSS BLUE SHIELD
AL51545029OtherBLUE CROSS BLUE SHIELD
AL630306047Medicaid
AL51545026OtherBLUE CROSS BLUE SHIELD
AL630302047Medicaid
AL630308047Medicaid
AL630309047Medicaid
AL51545030OtherBLUE CROSS BLUE SHIELD
AL630307047Medicaid
AL510I500024Medicare PIN