1205895059 NPI number — DR. DEBORAH ANN HINKLEY MD, MPH&TM

Table of content: DR. DEBORAH ANN HINKLEY MD, MPH&TM (NPI 1205895059)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1205895059 NPI number — DR. DEBORAH ANN HINKLEY MD, MPH&TM

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HINKLEY
Provider First Name:
DEBORAH
Provider Middle Name:
ANN
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
MD, MPH&TM
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1205895059
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
07/08/2007
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
10385 FOGGY BOTTOM RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
PENSACOLA
Provider Business Mailing Address State Name:
FL
Provider Business Mailing Address Postal Code:
32507-7227
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
950-492-3857
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
SENIOR MEDICAL OFFICER
Provider Second Line Business Practice Location Address:
USS THEODORE ROOSEVELT, CVN-71
Provider Business Practice Location Address City Name:
FPO AE
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
09599-2871
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
757-443-7466
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
03/21/2006

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 207Q00000X , with the licence number:  267154-1205 , registered in the state of UT ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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