Healthcare Provider Details

I. General information

NPI: 1972584514
Provider Name (Legal Business Name): MARK SIDNEY HINSON M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/10/2005
Last Update Date: 03/06/2024
Certification Date: 03/06/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

832 WESTOVER DR STE 200
COLUMBIA TN
38401-4843
US

IV. Provider business mailing address

410 42ND AVE N STE 400
NASHVILLE TN
37209-3658
US

V. Phone/Fax

Practice location:
  • Phone: 931-380-3033
  • Fax: 931-388-3401
Mailing address:
  • Phone: 615-329-7887
  • Fax: 615-346-6225

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code208600000X
TaxonomySurgery Physician
License Number30425
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: