Primary | Taxonomy Code | Taxonomy Specialty | License Number | License State |
---|---|---|---|---|
Y | 207X00000X | Orthopaedic Surgeon | 5101025072 | MI |
N | 207XX0005X | Sports Medicine Orthopaedic Surgeon | 5101025072 | MI |
NPI | 1124368923 |
---|---|
Provider Name | Dr. Jonathon Hinz |
First Address | Saint Clair Shores, MI 48080-3207 |
Second Address | Saint Clair Shores, MI 48080 |
Gender | M |
NPI Entity type | Individual |
Is Sole Proprietor | No |
Is Organization Subpart | N/A |
Enumeration Date | 15/02/2013 |
Last Update Date | 30/07/2019 |