Provider Demographics
NPI:1629000617
Name:HUTCHCROFT, JOHN ALLEN (APN)
Entity Type:Individual
Prefix:MR
First Name:JOHN
Middle Name:ALLEN
Last Name:HUTCHCROFT
Suffix:
Gender:M
Credentials:APN
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 6220
Mailing Address - Street 2:
Mailing Address - City:SPRINGDALE
Mailing Address - State:AR
Mailing Address - Zip Code:72766-6220
Mailing Address - Country:US
Mailing Address - Phone:479-738-1700
Mailing Address - Fax:
Practice Address - Street 1:705 PHILLIPS PL
Practice Address - Street 2:
Practice Address - City:HUNTSVILLE
Practice Address - State:AR
Practice Address - Zip Code:72740
Practice Address - Country:US
Practice Address - Phone:479-927-3100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-07
Last Update Date:2013-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARA01570363LF0000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363LF0000XPhysician Assistants & Advanced Practice Nursing ProvidersNurse PractitionerFamily
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR5T991OtherARKANSAS BLUE CROSS
AR136355758Medicaid
AR5T991Medicare ID - Type UnspecifiedMEDICARE
AR136355758Medicaid