MEDICARE: WILLIAM L. HINES, M.D., P.C.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	174400000X	Specialist	19133	CO

General Provider Information

NPI Number	:	1821194150
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	WILLIAM L. HINES, M.D., P.C.

Provider Business Mailing Address
First Line	:	2480 S DOWNING ST
Second Line	:	SUITE G-30
City	:	DENVER
State	:	CO
Zip	:	80210-5890
Country	:	US
Telephone Number	:	303-777-3277
Fax Number	:	303-698-9713

Provider Business Practice Location Address
First Line	:	2480 S DOWNING ST
Second Line	:	SUITE G-30
City	:	DENVER
State	:	CO
Zip	:	80210-5890
Country	:	US
Telephone Number	:	303-777-3277
Fax Number	:	303-698-9713

Authorized Official
Title or Position	:	MANAGING DIRECTOR
Name	:	MR. CHARLIE GOETZ
Credential	:
Telephone Number	:	303-777-3277

Provider Enumeration Date	:	09/15/2006
Last Update Date	:	04/06/2017

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