Healthcare Provider Details

I. General information

NPI: 1568807311
Provider Name (Legal Business Name): MICHAEL JERMAINE HINTON
Entity Type: Individual
Gender: Male
Sole Proprietor: N

Provider Other Name: MICHAEL JERMAINE HINTON M.D.

II. Dates (important events)

Enumeration Date: 05/07/2013
Last Update Date: 05/07/2013
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1514 JEFFERSON HWY BRENT HOUSE ROOM 634
NEW ORLEANS LA
70121-2429
US

IV. Provider business mailing address

1893 HAMPTON AVE
CHARLESTON SC
29405-8302
US

V. Phone/Fax

Practice location:
  • Phone: 504-842-9216
  • Fax: 504-842-3193
Mailing address:
  • Phone: 843-754-1382
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code390200000X
TaxonomyStudent in an Organized Health Care Education/Training Program
License Number
License Number State

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: