Doctor Name: | MR. KEITH D HUTTON |
NPI Number: | 1124282603 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | BS |
License Number: | |
Business Practice Address: | 2 Wickersham St Mangum, OK - 735549117 |
Business Phone Number: | 5807823337 |
Business Fax Number: | 5807823338 |
Mailing Address: | 715 N Georgia Ave, MANGUM |
State: | OK |
Postal Code: | 735542201 |
Phone Number: | 5807822567 |
Fax Number: | 5807823338 |
NPI Enumeration Date: | 07/15/2008 |
NPI Last Update Date: | 07/15/2008 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YA0400X |
License Number: | |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Addiction (Substance Use Disorder) |
Taxonomy Definition: |