Provider Demographics
NPI:1912946021
Name:HUTCHISON, GEORGE ROBERT (MD)
Entity Type:Individual
Prefix:
First Name:GEORGE
Middle Name:ROBERT
Last Name:HUTCHISON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 60
Mailing Address - Street 2:
Mailing Address - City:ROLAND
Mailing Address - State:AR
Mailing Address - Zip Code:72135-0060
Mailing Address - Country:US
Mailing Address - Phone:501-944-7417
Mailing Address - Fax:501-868-6361
Practice Address - Street 1:17105 HUNTING VALLEY RD
Practice Address - Street 2:
Practice Address - City:ROLAND
Practice Address - State:AR
Practice Address - Zip Code:72135
Practice Address - Country:US
Practice Address - Phone:501-944-7417
Practice Address - Fax:501-868-6361
Is Sole Proprietor?:No
Enumeration Date:2006-06-05
Last Update Date:2009-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
ARR4171207P00000X, 207PE0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No207PE0005XAllopathic & Osteopathic PhysiciansEmergency MedicineUndersea and Hyperbaric Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR50056OtherBCBS
AR114253001Medicaid
ARD04289Medicare UPIN
AR50056OtherBCBS