Provider Demographics
NPI:1619440260
Name:LOU ELLEN HUTCHESON MD PC
Entity Type:Organization
Organization Name:LOU ELLEN HUTCHESON MD PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OFFICE MANAGER
Authorized Official - Prefix:
Authorized Official - First Name:JOHNNIE
Authorized Official - Middle Name:
Authorized Official - Last Name:CARTER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:912-632-0884
Mailing Address - Street 1:1126 W 12TH ST
Mailing Address - Street 2:
Mailing Address - City:ALMA
Mailing Address - State:GA
Mailing Address - Zip Code:31510-1814
Mailing Address - Country:US
Mailing Address - Phone:912-632-0884
Mailing Address - Fax:912-632-2842
Practice Address - Street 1:1126 W 12TH ST
Practice Address - Street 2:
Practice Address - City:ALMA
Practice Address - State:GA
Practice Address - Zip Code:31510-1814
Practice Address - Country:US
Practice Address - Phone:912-632-0884
Practice Address - Fax:912-632-2842
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-01-07
Last Update Date:2019-01-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGroup - Single Specialty