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NPI Code Detail

MEDICARE: DR. JEROD L HINES M.D.

MEDICARE: DR. JEROD L HINES M.D.
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
1207X00000XOrthopaedic Surgery PhysicianMD214337OR
2207X00000XOrthopaedic Surgery PhysicianM-11820ID

General Provider Information

NPI Number : 1760726897
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. JEROD L HINES M.D.
Provider Business Mailing Address
First Line : 1060 W IDAHO BLVD
Second Line :
City : EMMETT
State : ID
Zip : 83617-9644
Country : US
Telephone Number : 208-954-1762
Fax Number :
Provider Business Practice Location Address
First Line : 1202 E LOCUST ST
Second Line :
City : EMMETT
State : ID
Zip : 83617-2715
Country : US
Telephone Number : 208-365-3563
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/15/2012
Last Update Date : 11/26/2025

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Directions to “ DR. JEROD L HINES M.D.” Practice Location

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