Healthcare Provider Details

I. General information

NPI: 1356349369
Provider Name (Legal Business Name): WILLIAM L HINES MD
Entity Type: Individual
Gender: Male
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/13/2005
Last Update Date: 04/10/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2480 S DOWNING ST G-30
DENVER CO
80210-5890
US

IV. Provider business mailing address

2480 S DOWNING ST G-30
DENVER CO
80210-5890
US

V. Phone/Fax

Practice location:
  • Phone: 303-777-3277
  • Fax: 303-698-9713
Mailing address:
  • Phone: 303-777-3277
  • Fax: 303-698-9713

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207W00000X
TaxonomyOphthalmology Physician
License Number19133
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: