1306891619 NPI number — DR. SARAH B HINKLEY O.D.

Table of content: DR. SARAH B HINKLEY O.D. (NPI 1306891619)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1306891619 NPI number — DR. SARAH B HINKLEY O.D.

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HINKLEY
Provider First Name:
SARAH
Provider Middle Name:
B
Provider Name Prefix Text:
DR.
Provider Name Suffix Text:
Provider Credential Text:
O.D.
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:
1306891619
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
02/04/2009
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
1310 CRAMER CIR
Provider Second Line Business Mailing Address:
ROOM 508
Provider Business Mailing Address City Name:
BIG RAPIDS
Provider Business Mailing Address State Name:
MI
Provider Business Mailing Address Postal Code:
49307-2736
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
231-591-2222
Provider Business Mailing Address Fax Number:
231-591-3991

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
1310 CRAMER CIR
Provider Second Line Business Practice Location Address:
ROOM 508
Provider Business Practice Location Address City Name:
BIG RAPIDS
Provider Business Practice Location Address State Name:
MI
Provider Business Practice Location Address Postal Code:
49307-2736
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
231-591-2222
Provider Business Practice Location Address Fax Number:
231-591-3991
Provider Enumeration Date:
05/24/2006

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: 152W00000X , with the licence number:  5478 , registered in the state of OH ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 152W00000X , with the licence number: 4244 , registered in the state of MI ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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

  • Identifier: SH004244 . This is a "BLUE CROSS" identifier , issued by the state of ( MI ) . This identifiers is of the category "OTHER".