Provider Demographics
NPI:1366748162
Name:HUTCHCRAFT, MEGAN LEIGH GLEASON (MD)
Entity type:Individual
Prefix:DR
First Name:MEGAN LEIGH
Middle Name:GLEASON
Last Name:HUTCHCRAFT
Suffix:
Gender:F
Credentials:MD
Other - Prefix:DR
Other - First Name:MEGAN
Other - Middle Name:LEIGH
Other - Last Name:GLEASON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MD
Mailing Address - Street 1:508 LINDEN DR
Mailing Address - Street 2:
Mailing Address - City:SAINT JOSEPH
Mailing Address - State:IL
Mailing Address - Zip Code:61873-9433
Mailing Address - Country:US
Mailing Address - Phone:630-674-1546
Mailing Address - Fax:
Practice Address - Street 1:339 WHITNEY HENDRICKSON BLDG 800 ROSE STREET
Practice Address - Street 2:
Practice Address - City:LEXINGTON
Practice Address - State:KY
Practice Address - Zip Code:40536-1267
Practice Address - Country:US
Practice Address - Phone:859-323-3975
Practice Address - Fax:859-323-1602
Is Sole Proprietor?:Yes
Enumeration Date:2011-01-27
Last Update Date:2020-08-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X, 390200000X
KY53835207VX0201X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No207VX0201XAllopathic & Osteopathic PhysiciansObstetrics & GynecologyGynecologic Oncology