Healthcare Provider Details

I. General information

NPI: 1396850400
Provider Name (Legal Business Name): DRS. HINKEBEIN, DAVIS & MCCORMICK, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/20/2006
Last Update Date: 07/07/2020
Certification Date: 07/07/2020
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9905 SHELBYVILLE RD
LOUISVILLE KY
40223-2907
US

IV. Provider business mailing address

9905 SHELBYVILLE RD
LOUISVILLE KY
40223-2907
US

V. Phone/Fax

Practice location:
  • Phone: 502-425-5166
  • Fax: 502-327-0526
Mailing address:
  • Phone: 502-425-5166
  • Fax: 502-327-0526

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208000000X
TaxonomyPediatrics Physician
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code2080A0000X
TaxonomyPediatric Adolescent Medicine Physician
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: DR. NICHOLAS M HINKEBEIN
Title or Position: SENIOR PARTNER
Credential: M.D.
Phone: 502-425-5166