=====================================================
General NPI Number Information
=====================================================
NPI Number | 1457358327
-----------------------------------------------------
Entity Type | Individual
-----------------------------------------------------
Provider Name | JOHN HOINES MD
-----------------------------------------------------
Gender | Male
-----------------------------------------------------
=====================================================
Dates
=====================================================
Enumeration Date | 07/06/2005
-----------------------------------------------------
Last Update Date | 03/10/2011
-----------------------------------------------------
=====================================================
Provider Practice Location Address
=====================================================
Address Line | 1630 ADAMS ST
-----------------------------------------------------
City | MANKATO
-----------------------------------------------------
State | MN
-----------------------------------------------------
Zip | 56001-4801
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 507-345-6151
-----------------------------------------------------
Fax | 507-625-1096
-----------------------------------------------------
=====================================================
Provider Business Mailing Address
=====================================================
Address Line | 1630 ADAMS ST
-----------------------------------------------------
City | MANKATO
-----------------------------------------------------
State | MN
-----------------------------------------------------
Zip | 56001-4801
-----------------------------------------------------
Country | US
-----------------------------------------------------
Telephone | 507-345-6151
-----------------------------------------------------
Fax | 507-625-1096
-----------------------------------------------------
=====================================================
Authorized Official
=====================================================
Title or Position |
-----------------------------------------------------
Name |
-----------------------------------------------------
Credential |
-----------------------------------------------------
Telephone |
-----------------------------------------------------
=====================================================
Scope of Practice (Provider's specialty)
=====================================================
Taxonomy #1
-----------------------------------------------------
Taxonomy Code | 207W00000X
-----------------------------------------------------
Taxonomy Name | Ophthalmology Physician
-----------------------------------------------------
License Number | 24634
-----------------------------------------------------
License Number State | MN
-----------------------------------------------------