Provider Demographics
NPI:1538271176
Name:HUTCHINGS, JONATHAN (DO)
Entity type:Individual
Prefix:
First Name:JONATHAN
Middle Name:
Last Name:HUTCHINGS
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 1:501 ADESA PKWY
Mailing Address - Street 2:SUITE 300
Mailing Address - City:LENOIR CITY
Mailing Address - State:TN
Mailing Address - Zip Code:37771-6725
Mailing Address - Country:US
Mailing Address - Phone:865-988-6922
Mailing Address - Fax:865-988-6296
Practice Address - Street 1:501 ADESA PKWY
Practice Address - Street 2:SUITE 300
Practice Address - City:LENOIR CITY
Practice Address - State:TN
Practice Address - Zip Code:37771-6725
Practice Address - Country:US
Practice Address - Phone:865-988-6922
Practice Address - Fax:865-988-6296
Is Sole Proprietor?:No
Enumeration Date:2006-08-31
Last Update Date:2014-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNDO2643207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
SC008422Medicaid
SCAA05488032Medicare PIN
SCI12082Medicare UPIN
8032Medicare ID - Type Unspecified
SC008422Medicaid