Provider Demographics
NPI:1851060248
Name:HUTCHISON, BERT
Entity Type:Individual
Prefix:
First Name:BERT
Middle Name:
Last Name:HUTCHISON
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6547 BERKEY SOUTHERN RD
Mailing Address - Street 2:
Mailing Address - City:WHITEHOUSE
Mailing Address - State:OH
Mailing Address - Zip Code:43571-9608
Mailing Address - Country:US
Mailing Address - Phone:419-346-9557
Mailing Address - Fax:
Practice Address - Street 1:6547 BERKEY SOUTHERN RD
Practice Address - Street 2:
Practice Address - City:WHITEHOUSE
Practice Address - State:OH
Practice Address - Zip Code:43571-9608
Practice Address - Country:US
Practice Address - Phone:419-346-9557
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-09
Last Update Date:2021-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171WH0202XOther Service ProvidersContractorHome Modifications
No171W00000XOther Service ProvidersContractor