Provider Demographics
NPI:1902836307
Name:HUTTON, ROBERT M (MD)
Entity Type:Individual
Prefix:
First Name:ROBERT
Middle Name:M
Last Name:HUTTON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:1 VANTAGE WAY
Mailing Address - Street 2:SUITE B240
Mailing Address - City:NASHVILLE
Mailing Address - State:TN
Mailing Address - Zip Code:37228-1515
Mailing Address - Country:US
Mailing Address - Phone:615-329-4020
Mailing Address - Fax:615-327-4403
Practice Address - Street 1:2000 CHURCH STREET
Practice Address - Street 2:
Practice Address - City:NASHVILLE
Practice Address - State:TN
Practice Address - Zip Code:37203
Practice Address - Country:US
Practice Address - Phone:800-251-2014
Practice Address - Fax:615-284-3854
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-03
Last Update Date:2010-06-10
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
TN12717207P00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3110216OtherSTONES RIVER IPA
KY64749872OtherKY MEDICAID
TN4040144OtherBCBS
TNB03925Medicare UPIN
NE3180770Medicare ID - Type Unspecified
TN3180779Medicare ID - Type Unspecified