Provider Demographics
NPI:1851532402
Name:HUTSON, EDWARD DOUGLAS JR (DPM)
Entity Type:Individual
Prefix:
First Name:EDWARD
Middle Name:DOUGLAS
Last Name:HUTSON
Suffix:JR
Gender:M
Credentials:DPM
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:42 N 3RD ST
Mailing Address - Street 2:FIRST FLOOR
Mailing Address - City:EASTON
Mailing Address - State:PA
Mailing Address - Zip Code:18042-7737
Mailing Address - Country:US
Mailing Address - Phone:610-253-4821
Mailing Address - Fax:
Practice Address - Street 1:42 N 3RD ST
Practice Address - Street 2:FIRST FLOOR
Practice Address - City:EASTON
Practice Address - State:PA
Practice Address - Zip Code:18042-7737
Practice Address - Country:US
Practice Address - Phone:610-253-4821
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-11
Last Update Date:2009-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASC005918213ES0103X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes213ES0103XPodiatric Medicine & Surgery Service ProvidersPodiatristFoot & Ankle Surgery