Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207Y00000X | Otolaryngologist (ENT Doctor) | 26630 | MS |
N | 207Y00000X | Otolaryngologist (ENT Doctor) | 49529 | AZ |
NPI | 1023455169 |
---|---|
Provider Name | Dr. John P Hines |
First Address | Flowood, MS 39232-9306 |
Second Address | Flowood, MS 39232-9306 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 30/05/2013 |
Last Update Date | 03/09/2019 |