Provider Demographics
NPI:1972787414
Name:DAVID N. HINKLEY, O.D.
Entity type:Organization
Organization Name:DAVID N. HINKLEY, O.D.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OPTOMETRIST
Authorized Official - Prefix:DR
Authorized Official - First Name:DAVID
Authorized Official - Middle Name:NIEL
Authorized Official - Last Name:HINKLEY
Authorized Official - Suffix:
Authorized Official - Credentials:OD
Authorized Official - Phone:719-852-3442
Mailing Address - Street 1:37 WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:MONTE VISTA
Mailing Address - State:CO
Mailing Address - Zip Code:81144-1406
Mailing Address - Country:US
Mailing Address - Phone:719-852-3442
Mailing Address - Fax:719-852-9791
Practice Address - Street 1:37 WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:MONTE VISTA
Practice Address - State:CO
Practice Address - Zip Code:81144-1406
Practice Address - Country:US
Practice Address - Phone:719-852-3442
Practice Address - Fax:719-852-9791
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-12-19
Last Update Date:2007-12-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COCO1289332H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes332H00000XSuppliersEyewear Supplier
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO08012890Medicaid
CO08012890Medicaid
COT60870Medicare UPIN