Healthcare Provider Details

I. General information

NPI: 1073520870
Provider Name (Legal Business Name): RICHARD M HINES M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/02/2006
Last Update Date: 03/29/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

55 ARCH ST 3A
AKRON OH
44304-1423
US

IV. Provider business mailing address

525 E MARKET ST ANNEX 3
AKRON OH
44304-1619
US

V. Phone/Fax

Practice location:
  • Phone: 330-375-3584
  • Fax: 330-375-6306
Mailing address:
  • Phone: 330-375-7512
  • Fax: 330-375-3445

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number35.040842
License Number StateOH

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: