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NPI Code Detail

MEDICARE: DARYL JEAN HINES PA-C

MEDICARE: DARYL JEAN HINES PA-C
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1363A00000XPhysician Assistant50.006340OH

General Provider Information

NPI Number : 1386257046
Entity Type Code : Individual
Provider Name (Legal Business Name) : DARYL JEAN HINES PA-C
Provider Business Mailing Address
First Line : 7706 OLENTANGY RIVER RD
Second Line :
City : COLUMBUS
State : OH
Zip : 43235-1317
Country : US
Telephone Number : 614-436-8888
Fax Number : 614-413-3094
Provider Business Practice Location Address
First Line : 7706 OLENTANGY RIVER RD
Second Line :
City : COLUMBUS
State : OH
Zip : 43235-1317
Country : US
Telephone Number : 614-436-8888
Fax Number : 614-413-3094
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 08/24/2020
Last Update Date : 12/13/2024

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