1861064164 NPI number — DAVID J HINNENKAMP MD

Table of content: DAVID J HINNENKAMP MD (NPI 1861064164)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1861064164 NPI number — DAVID J HINNENKAMP MD

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
HINNENKAMP
Provider First Name:
DAVID
Provider Middle Name:
J
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
MD
Provider Gender Code:
M

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:
1861064164
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
09/06/2024
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
WBAMC
Provider Second Line Business Mailing Address:
5005 N PIEDRAS STREET
Provider Business Mailing Address City Name:
EL PASO
Provider Business Mailing Address State Name:
TX
Provider Business Mailing Address Postal Code:
79920-5001
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
915-742-2180
Provider Business Mailing Address Fax Number:
915-742-4363

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
BRIAN D. ALLGOOD ARMY COMMUNITY HOSPITAL
Provider Second Line Business Practice Location Address:
UNIT 15281. BLDG 3031
Provider Business Practice Location Address City Name:
APO
Provider Business Practice Location Address State Name:
AP
Provider Business Practice Location Address Postal Code:
96271
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
80-500-4011
Provider Business Practice Location Address Fax Number:
Provider Enumeration Date:
07/15/2021

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: 390200000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "N" .
  • Taxonomy code: 207R00000X , with the licence number: 35471 , registered in the state of NE ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

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





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