Provider Demographics
NPI:1760473755
Name:HUTCHINSON, CHARLES L (MD)
Entity Type:Individual
Prefix:DR
First Name:CHARLES
Middle Name:L
Last Name:HUTCHINSON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Other - Credentials:
Mailing Address - Street 1:205 HAWKINS STORE RD
Mailing Address - Street 2:SUITE B 1
Mailing Address - City:KENNESAW
Mailing Address - State:GA
Mailing Address - Zip Code:30144
Mailing Address - Country:US
Mailing Address - Phone:770-928-0862
Mailing Address - Fax:770-928-2286
Practice Address - Street 1:205 HAWKINS STORE RD
Practice Address - Street 2:SUITE B 1
Practice Address - City:KENNESAW
Practice Address - State:GA
Practice Address - Zip Code:30144
Practice Address - Country:US
Practice Address - Phone:770-928-0862
Practice Address - Fax:770-928-2286
Is Sole Proprietor?:No
Enumeration Date:2005-10-31
Last Update Date:2011-12-12
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
GA055567208000000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208000000XAllopathic & Osteopathic PhysiciansPediatrics