Healthcare Provider Details

I. General information

NPI: 1376283440
Provider Name (Legal Business Name): MICHAEL HINTON MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/29/2022
Last Update Date: 07/22/2026
Certification Date: 07/22/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5255 E STOP 11 RD STE 310
INDIANAPOLIS IN
46237-6341
US

IV. Provider business mailing address

PO BOX 781076
DETROIT MI
48278-1008
US

V. Phone/Fax

Practice location:
  • Phone: 317-781-1133
  • Fax: 317-528-7099
Mailing address:
  • Phone: 317-528-4800
  • Fax: 317-865-1479

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number StateIN
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number01092034A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: