Provider Demographics
NPI:1669076386
Name:HUTCHINGS, WENDELL (PHARMD)
Entity type:Individual
Prefix:DR
First Name:WENDELL
Middle Name:
Last Name:HUTCHINGS
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4080 BLOOMFIELD RD
Mailing Address - Street 2:
Mailing Address - City:MACON
Mailing Address - State:GA
Mailing Address - Zip Code:31206-3643
Mailing Address - Country:US
Mailing Address - Phone:478-781-4018
Mailing Address - Fax:
Practice Address - Street 1:4080 BLOOMFIELD RD
Practice Address - Street 2:
Practice Address - City:MACON
Practice Address - State:GA
Practice Address - Zip Code:31206-3643
Practice Address - Country:US
Practice Address - Phone:478-781-4018
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-11-23
Last Update Date:2020-11-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLPS60760183500000X
GARPH031670183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist