Individual
KEITH LEON HUTCHINS JR.
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA-C, DHSC
Taxonomy
Speciality
Code
Description
License number
State
363AS0400X
Surgical Physician Assistant
Primary
0010-00581
NC
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0010-00581
STATE LICENSE
NC
01
—
1009
STATE LICENSE FOR PA'S
SC
05
—
1376536714
—
NC
Enumeration date
08/30/2005
Last updated
03/07/2023
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