Provider Demographics
NPI:1730104845
Name:HUTCHISON, JASON A (DC)
Entity Type:Individual
Prefix:MR
First Name:JASON
Middle Name:A
Last Name:HUTCHISON
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1508 NE 96TH ST
Mailing Address - Street 2:SUITE B
Mailing Address - City:LIBERTY
Mailing Address - State:MO
Mailing Address - Zip Code:64068-1348
Mailing Address - Country:US
Mailing Address - Phone:816-407-7200
Mailing Address - Fax:816-407-7222
Practice Address - Street 1:1508 NE 96TH ST
Practice Address - Street 2:SUITE B
Practice Address - City:LIBERTY
Practice Address - State:MO
Practice Address - Zip Code:64068-1348
Practice Address - Country:US
Practice Address - Phone:816-407-7200
Practice Address - Fax:816-407-7222
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-12
Last Update Date:2016-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MODRC2006008609111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH2212957Medicaid
OH2212957Medicaid
OHTR4035301Medicare PIN