Provider Demographics
NPI:1134231756
Name:HUTCHINGS, HEATHER MCCOY (DO)
Entity type:Individual
Prefix:
First Name:HEATHER
Middle Name:MCCOY
Last Name:HUTCHINGS
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:460 MEDICAL PARK DR STE 108B
Mailing Address - Street 2:
Mailing Address - City:LENOIR CITY
Mailing Address - State:TN
Mailing Address - Zip Code:37772-5782
Mailing Address - Country:US
Mailing Address - Phone:865-562-3232
Mailing Address - Fax:865-218-7526
Practice Address - Street 1:460 MEDICAL PARK DR STE 108B
Practice Address - Street 2:
Practice Address - City:LENOIR CITY
Practice Address - State:TN
Practice Address - Zip Code:37772-5782
Practice Address - Country:US
Practice Address - Phone:865-562-3232
Practice Address - Fax:865-218-7526
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2024-02-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC843207Q00000X
TNDO2617207Q00000X
TN2617207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
SCI13135Medicare UPIN
SC008431Medicaid
SCAA05736305Medicare PIN
SCAA05738032Medicare PIN
SC8032Medicare ID - Type Unspecified