Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207V00000X | Obstetrician & Gynecologist | 18161 | CO |
NPI | 1013165612 |
---|---|
Provider Name | John Mahlon Hutto |
First Address | Brutus, MI 49716-9500 |
Second Address | Brutus, MI 49716-9500 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 08/09/2008 |
Last Update Date | 08/09/2008 |