Provider Demographics
NPI:1700819257
Name:DEPP-HUTCHINSON, WILLIAM SCOTT (MD)
Entity Type:Individual
Prefix:DR
First Name:WILLIAM
Middle Name:SCOTT
Last Name:DEPP-HUTCHINSON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:DR
Other - First Name:WILLIAM
Other - Middle Name:SCOTT
Other - Last Name:HUTCHINSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:5690 SHAFFER RD
Mailing Address - Street 2:
Mailing Address - City:DU BOIS
Mailing Address - State:PA
Mailing Address - Zip Code:15801-3870
Mailing Address - Country:US
Mailing Address - Phone:814-375-6817
Mailing Address - Fax:814-375-0922
Practice Address - Street 1:5690 SHAFFER RD
Practice Address - Street 2:
Practice Address - City:DU BOIS
Practice Address - State:PA
Practice Address - Zip Code:15801-3870
Practice Address - Country:US
Practice Address - Phone:814-375-6817
Practice Address - Fax:814-375-0922
Is Sole Proprietor?:No
Enumeration Date:2006-07-08
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAMD-042489-L207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
PAMD-042489-LOtherSTATE LISCENCE
PAMAID 1268290Medicaid
PAMAID 1268290Medicaid
PAMAID 1268290Medicaid