Provider Demographics
NPI:1336124155
Name:HYNDMAN, CATHERINE JEANNE (MD)
Entity type:Individual
Prefix:
First Name:CATHERINE
Middle Name:JEANNE
Last Name:HYNDMAN
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 130
Mailing Address - Street 2:
Mailing Address - City:DILLINGHAM
Mailing Address - State:AK
Mailing Address - Zip Code:99576
Mailing Address - Country:US
Mailing Address - Phone:907-842-9218
Mailing Address - Fax:907-842-9368
Practice Address - Street 1:6000 KANAKANAK RD
Practice Address - Street 2:
Practice Address - City:DILLINGHAM
Practice Address - State:AK
Practice Address - Zip Code:99576
Practice Address - Country:US
Practice Address - Phone:907-842-5201
Practice Address - Fax:907-842-9250
Is Sole Proprietor?:No
Enumeration Date:2005-12-14
Last Update Date:2011-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AK4489207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
AKMD4956Medicaid
8EZ334Medicare ID - Type Unspecified
8EZ304Medicare ID - Type Unspecified
8EZ224Medicare ID - Type Unspecified
8EZ254Medicare ID - Type Unspecified
E62613Medicare UPIN
8EZ344Medicare ID - Type Unspecified
8EZ364Medicare ID - Type Unspecified
AKMD4956Medicaid
8EZ234Medicare ID - Type Unspecified
8EZ194Medicare ID - Type Unspecified
8EZ245Medicare ID - Type Unspecified
8EZ264Medicare ID - Type Unspecified
8EZ394Medicare ID - Type Unspecified
8EZ214Medicare ID - Type Unspecified
8EZ274Medicare ID - Type Unspecified
8EZ294Medicare ID - Type Unspecified
8EZ314Medicare ID - Type Unspecified
8EZ354Medicare ID - Type Unspecified
8EZ204Medicare ID - Type Unspecified