Provider Demographics
NPI:1730576703
Name:HUTSON, JEREMY WADE (DO)
Entity type:Individual
Prefix:
First Name:JEREMY
Middle Name:WADE
Last Name:HUTSON
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 1:55 HOLLY SPRINGS PARK DR
Mailing Address - Street 2:
Mailing Address - City:FRANKLIN
Mailing Address - State:NC
Mailing Address - Zip Code:28734-0719
Mailing Address - Country:US
Mailing Address - Phone:828-349-3550
Mailing Address - Fax:
Practice Address - Street 1:55 HOLLY SPRINGS PARK DR
Practice Address - Street 2:
Practice Address - City:FRANKLIN
Practice Address - State:NC
Practice Address - Zip Code:28734-0719
Practice Address - Country:US
Practice Address - Phone:828-349-3550
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2015-04-17
Last Update Date:2021-08-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2016-02359207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine