Hinman, Mark Wallace
Hinman, Mark Wallace is an sole proprietor health care provider with primary practice located at 1350 Tulip St , Longmont CO 80501-3140. He recently has only one registered license in Allopathic & Osteopathic Physicians / Family Medicine, which is considered as his primary health care specialty. Hinman, Mark Wallace can be contacted via phone (303) 776-6872.Contact Information
Primary practice address
1350 Tulip St
Longmont CO 80501-3140
Phone: (303) 776-6872
Fax: (303) 776-2501
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Allopathic & Osteopathic Physicians / Family Medicine | 207Q00000X | 28820 | Colorado |
Profile Details
| NPI number | 1750385415 |
|---|---|
| LBN Legal business name | Hinman, Mark Wallace |
| Credentials | Doctor of Medicine (MD) |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Jun 10th, 2005 |
| Last updated | Jan 19th, 2013 - about 11 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1750385415 | NPPES |
| Colorado | MEDICAID | 04021093 |
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