Healthcare Provider Details

I. General information

NPI: 1871583658
Provider Name (Legal Business Name): ANGELA L. HINDS M.D.
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/24/2005
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10440 E RIGGS RD
SUN LAKES AZ
85248-7751
US

IV. Provider business mailing address

PO BOX 16455
MESA AZ
85211-6455
US

V. Phone/Fax

Practice location:
  • Phone: 480-883-3640
  • Fax: 480-883-3643
Mailing address:
  • Phone: 480-615-2050
  • Fax: 480-962-0523

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number24157
License Number StateAZ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: