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General NPI Number Information
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NPI Number | 1437534633
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Entity Type | Individual
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Provider Name | MARK HINTON ATC, FR, FDM
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Gender | Male
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Dates
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Enumeration Date | 07/29/2015
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Last Update Date | 07/29/2015
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Provider Practice Location Address
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Address Line | 131 BARNHILL ARENA OFFICE OFFICE 116A
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City | FAYETTEVILLE
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State | AR
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Zip | 72701
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Country | US
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Telephone | 479-575-5150
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Fax |
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Provider Business Mailing Address
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Address Line | 6258 W COPPER RIDGE LN
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City | FAYETTEVILLE
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State | AR
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Zip | 72704-6071
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Country | US
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Telephone | 473-249-5487
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Fax |
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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 | 174400000X
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Taxonomy Name | Specialist
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License Number | AT 469
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License Number State | AR
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