Provider Demographics
NPI:1609399609
Name:HUTCHINSON CLINIC ONCOLOGY DISPENSARY
Entity Type:Organization
Organization Name:HUTCHINSON CLINIC ONCOLOGY DISPENSARY
Other - Org Name:HUTCHINSON CLINIC, P.A.
Other - Org Type:Other Name
Authorized Official - Title/Position:CEO
Authorized Official - Prefix:
Authorized Official - First Name:MICHAEL
Authorized Official - Middle Name:
Authorized Official - Last Name:HECK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:620-669-2500
Mailing Address - Street 1:2101 N WALDRON ST
Mailing Address - Street 2:
Mailing Address - City:HUTCHINSON
Mailing Address - State:KS
Mailing Address - Zip Code:67502-1131
Mailing Address - Country:US
Mailing Address - Phone:620-669-2500
Mailing Address - Fax:620-669-2598
Practice Address - Street 1:2101 N WALDRON ST
Practice Address - Street 2:
Practice Address - City:HUTCHINSON
Practice Address - State:KS
Practice Address - Zip Code:67502-1131
Practice Address - Country:US
Practice Address - Phone:620-669-2500
Practice Address - Fax:620-694-2038
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-07-21
Last Update Date:2022-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207RH0003XAllopathic & Osteopathic PhysiciansInternal MedicineHematology & OncologyGroup - Multi-Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KS100087920AMedicaid