Individual
RANDALL R HUTCHINGS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
1510 12TH AVE RD, STE 200, NAMPA, ID 83686
(208) 302-6800
(208) 302-6855
Mailing address
3340 E GOLDSTONE WAY, MERIDIAN, ID 83642-1026
(208) 302-6800
(208) 302-6855
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
M4670
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
003733600
—
ID
Enumeration date
06/11/2006
Last updated
11/09/2017
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