Provider Demographics
NPI:1134206816
Name:HUTCHINSON, ANDREW JOHN (DO)
Entity type:Individual
Prefix:DR
First Name:ANDREW
Middle Name:JOHN
Last Name:HUTCHINSON
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:711 N FRANKLIN ST
Mailing Address - Street 2:
Mailing Address - City:WHITEVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28472-3412
Mailing Address - Country:US
Mailing Address - Phone:910-640-2051
Mailing Address - Fax:910-640-2059
Practice Address - Street 1:701 JEFFERSON ST
Practice Address - Street 2:
Practice Address - City:WHITEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28472-3704
Practice Address - Country:US
Practice Address - Phone:910-640-2051
Practice Address - Fax:910-640-2059
Is Sole Proprietor?:No
Enumeration Date:2006-11-01
Last Update Date:2017-10-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC200200238208600000X, 2086S0129X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
No2086S0129XAllopathic & Osteopathic PhysiciansSurgeryVascular Surgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
NC89131FFMedicaid
NC34D1028886OtherCLIA
NC200200238OtherLICENCE NUMBER
NC2401245BMedicare ID - Type UnspecifiedGROUP # FOR HIS CORP
NCH71853Medicare UPIN