Healthcare Provider Details

I. General information

NPI: 1518911247
Provider Name (Legal Business Name): DEBORAH LEE HINKLE PHYSICIAN ASSISTANT
Entity Type: Individual
Gender: Female
Sole Proprietor: X

II. Dates (important events)

Enumeration Date: 05/19/2006
Last Update Date: 07/09/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

STONES RIVER HOSPITAL 324 DOOLITTLE ROAD
WOODBURY TN
37190-5041
US

IV. Provider business mailing address

308 ETON RD
SMYRNA TN
37167-4203
US

V. Phone/Fax

Practice location:
  • Phone: 615-563-4001
  • Fax:
Mailing address:
  • Phone: 615-512-1092
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code363A00000X
TaxonomyPhysician Assistant
License NumberPA0000000096
License Number StateTN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: