Provider Demographics
NPI:1285910133
Name:HALES, FLINT C (MD)
Entity type:Individual
Prefix:DR
First Name:FLINT
Middle Name:C
Last Name:HALES
Suffix:
Gender:M
Credentials:MD
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Mailing Address - Street 1:20713 E OCOTILLO RD
Mailing Address - Street 2:STE #100
Mailing Address - City:QUEEN CREEK
Mailing Address - State:AZ
Mailing Address - Zip Code:85142-6117
Mailing Address - Country:US
Mailing Address - Phone:480-882-9993
Mailing Address - Fax:480-248-2377
Practice Address - Street 1:20713 E OCOTILLO RD
Practice Address - Street 2:STE #100
Practice Address - City:QUEEN CREEK
Practice Address - State:AZ
Practice Address - Zip Code:85142-6117
Practice Address - Country:US
Practice Address - Phone:480-882-9993
Practice Address - Fax:480-248-2377
Is Sole Proprietor?:No
Enumeration Date:2011-10-24
Last Update Date:2013-08-13
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
WI3838-850390200000X
WI57426-20390200000X
AZ47348207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI3838-850OtherTEP