Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207R00000X | Internist | 7646 | AZ |
Y | 111NI0900X | Internist | 7646 | AZ |
NPI | 1003148990 |
---|---|
Provider Name | Dr. Clarence James Hindman |
First Address | Tucson, AZ 85740-6807 |
Second Address | Oro Valley, AZ 85755-4747 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | Yes |
Is Organization Subpart | N/A |
Enumeration Date | 03/02/2010 |
Last Update Date | 03/02/2010 |