Provider Demographics
NPI:1508834474
Name:HUTSINPILLER, MOLLY (MD)
Entity Type:Individual
Prefix:DR
First Name:MOLLY
Middle Name:
Last Name:HUTSINPILLER
Suffix:
Gender:F
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:PO BOX 129
Mailing Address - Street 2:
Mailing Address - City:TOK
Mailing Address - State:AK
Mailing Address - Zip Code:99780-0129
Mailing Address - Country:US
Mailing Address - Phone:907-883-5855
Mailing Address - Fax:
Practice Address - Street 1:MP 123 GLENN HWY
Practice Address - Street 2:
Practice Address - City:TOK
Practice Address - State:AK
Practice Address - Zip Code:99780-0129
Practice Address - Country:US
Practice Address - Phone:907-883-5855
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-03-08
Last Update Date:2021-05-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WA33833207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AZ890956Medicaid
NM00453749Medicaid
CO01330638Medicaid
CO01330638Medicaid
320050Medicare Oscar/Certification
AZ890956Medicaid