Keith D Hutton, BS

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

Practice address

2 Wickersham St
Mangum, OK 73554-9117

Phone

(580) 782-3337

Fax

(580) 782-3338

NPI assigned

Jul 15, 2008

Sex

Male

Sole proprietor

Yes

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Bachelor of Science

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Jul 15, 2008.

{
    "created_epoch": "1216080000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1216080000000",
    "number": "1124282603",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "715 N GEORGIA AVE",
            "city": "MANGUM",
            "state": "OK",
            "postal_code": "735542201",
            "telephone_number": "580-782-2567",
            "fax_number": "580-782-3338"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 WICKERSHAM ST",
            "city": "MANGUM",
            "state": "OK",
            "postal_code": "735549117",
            "telephone_number": "580-782-3337",
            "fax_number": "580-782-3338"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HUTTON",
        "first_name": "KEITH",
        "middle_name": "D",
        "name_prefix": "Mr.",
        "credential": "BS",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2008-07-15",
        "last_updated": "2008-07-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Greer County Special Ambulance Service District
• Greer County Special Ambulance Service District
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• Brittany Hand, DDS
• Shelia Annette Holmes, BA
• Jackson County Memorial Hospital Authority
• Laretha Johnson-Vincent
• Renee Richelle Klassen, BA.BHRS
• Wendy E. Lamb
• Maria Lara

• All providers in Mangum, OK
• Addiction (Substance Use Disorder) Counselor in Oklahoma

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 15, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.