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General NPI Number Information
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NPI Number | 1760626147
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Entity Type | Organization
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Legal Business Name | HINTON HEALTHCARE GROUP
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Dates
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Enumeration Date | 04/29/2009
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Last Update Date | 04/29/2009
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Provider Practice Location Address
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Address Line | 300 MEDICAL PLZ SUITE 230
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City | LAKE ST LOUIS
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State | MO
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Zip | 63367-1481
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Country | US
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Telephone | 636-625-1111
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Fax | 636-625-8566
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Provider Business Mailing Address
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Address Line | 17204 LAFAYETTE TRAILS DR
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City | WILDWOOD
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State | MO
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Zip | 63038-1386
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Country | US
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Telephone | 636-898-1082
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Fax | 636-625-8566
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Authorized Official
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Title or Position | PRESIDENT
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Name | DR. PAUL ANTHONY HINTON
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Credential | M.D.
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Telephone | 314-369-9061
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 208000000X
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Taxonomy Name | Pediatrics Physician
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License Number | 2006003131
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License Number State | MO
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Taxonomy #2
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Taxonomy Code | 207R00000X
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Taxonomy Name | Internal Medicine Physician
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License Number | 2006003131
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License Number State | MO
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