Provider Demographics
NPI:1902998149
Name:HUTCHENS, KATHRYN S (MD)
Entity Type:Individual
Prefix:
First Name:KATHRYN
Middle Name:S
Last Name:HUTCHENS
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1919 STATE ST
Mailing Address - Street 2:SUITE 460
Mailing Address - City:NEW ALBANY
Mailing Address - State:IN
Mailing Address - Zip Code:47150
Mailing Address - Country:US
Mailing Address - Phone:812-944-2040
Mailing Address - Fax:812-944-2248
Practice Address - Street 1:1919 STATE ST
Practice Address - Street 2:SUITE 460
Practice Address - City:NEW ALBANY
Practice Address - State:IN
Practice Address - Zip Code:47150
Practice Address - Country:US
Practice Address - Phone:812-944-2040
Practice Address - Fax:812-944-2248
Is Sole Proprietor?:Yes
Enumeration Date:2006-09-28
Last Update Date:2008-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01031260A207RG0100X
KY22112207RG0100X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207RG0100XAllopathic & Osteopathic PhysiciansInternal MedicineGastroenterology
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY000000039791OtherANTHEM BCBS
7600037OtherUNITED HEALTHCARE
IN000000039791OtherANTHEM BCBS
IN000000039791OtherANTHEM BCBS
B28675Medicare UPIN