Provider Demographics
NPI:1639368152
Name:HUTCHISON, JOE ROBERT (MD)
Entity Type:Individual
Prefix:
First Name:JOE
Middle Name:ROBERT
Last Name:HUTCHISON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:100 W 16TH ST
Mailing Address - Street 2:
Mailing Address - City:EUREKA
Mailing Address - State:KS
Mailing Address - Zip Code:67045-1064
Mailing Address - Country:US
Mailing Address - Phone:620-583-7451
Mailing Address - Fax:620-583-6884
Practice Address - Street 1:118 SOUTH WABASH
Practice Address - Street 2:
Practice Address - City:HOWARD
Practice Address - State:KS
Practice Address - Zip Code:67349
Practice Address - Country:US
Practice Address - Phone:620-374-2650
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-10-22
Last Update Date:2016-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS04-20564207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine