Provider Demographics
NPI:1124174081
Name:HINDS, MICHAEL W (MD)
Entity type:Individual
Prefix:
First Name:MICHAEL
Middle Name:W
Last Name:HINDS
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
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Other - Credentials:
Mailing Address - Street 1:215 HAWKS RD
Mailing Address - Street 2:SUITE 6
Mailing Address - City:MARTIN
Mailing Address - State:TN
Mailing Address - Zip Code:38237-2708
Mailing Address - Country:US
Mailing Address - Phone:731-587-3454
Mailing Address - Fax:731-587-3460
Practice Address - Street 1:215 HAWKS RD
Practice Address - Street 2:SUITE 6
Practice Address - City:MARTIN
Practice Address - State:TN
Practice Address - Zip Code:38237-2708
Practice Address - Country:US
Practice Address - Phone:731-587-3454
Practice Address - Fax:731-587-3460
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-25
Last Update Date:2015-03-23
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
TN0000011832207R00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207R00000XAllopathic & Osteopathic PhysiciansInternal Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
TNP00168717OtherRAILROAD MEDICARE
TN4086346OtherBCBS
TN3838387Medicaid
TN4086346OtherBCBS
TNB03927Medicare UPIN