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General NPI Number Information
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NPI Number | 1194780171
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Entity Type | Individual
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Provider Name | JOHN H HINES M.D.
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Gender | Male
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Dates
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Enumeration Date | 04/20/2006
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Last Update Date | 07/24/2024
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Provider Practice Location Address
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Address Line | 120 W BROADWAY
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City | LOUISVILLE
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State | KY
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Zip | 40202-2110
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Country | US
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Telephone | 502-772-8662
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Fax | 502-996-8309
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Provider Business Mailing Address
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Address Line | PO BOX 950202
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City | LOUISVILLE
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State | KY
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Zip | 40295-0202
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Country | US
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Telephone | 502-969-6552
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Fax | 502-212-1358
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207Q00000X
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Taxonomy Name | Family Medicine Physician
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License Number | 16791
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License Number State | KY
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