Provider Demographics
NPI:1952455685
Name:HUTCHINSON, MARCUS MARTIN (PT)
Entity Type:Individual
Prefix:MR
First Name:MARCUS
Middle Name:MARTIN
Last Name:HUTCHINSON
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
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Other - Credentials:
Mailing Address - Street 1:1000 JOHNSON FERRY RD
Mailing Address - Street 2:SUITE A-12
Mailing Address - City:MARIETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30068-2114
Mailing Address - Country:US
Mailing Address - Phone:404-367-2085
Mailing Address - Fax:770-579-7060
Practice Address - Street 1:1000 JOHNSON FERRY RD
Practice Address - Street 2:SUITE A-12
Practice Address - City:MARIETTA
Practice Address - State:GA
Practice Address - Zip Code:30068-2114
Practice Address - Country:US
Practice Address - Phone:404-367-2085
Practice Address - Fax:770-579-7060
Is Sole Proprietor?:No
Enumeration Date:2007-01-22
Last Update Date:2016-12-06
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
GAPT003354225100000X, 2251S0007X, 2251X0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
No2251S0007XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistSports
No2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA65BBDDCMedicare ID - Type Unspecified