| Mark W. Hinman, Md, Llc | |
|
1350 Tulip St Longmont CO 80501-3140 | |
| (303) 776-6872 | |
| (303) 776-2501 |
| Full Name | Mark W. Hinman, Md, Llc |
|---|---|
| Speciality | Clinic/Center |
| Location | 1350 Tulip St, Longmont, Colorado |
| Authorized Official Name and Position | Mark Wallace Hinman (OWNER) |
| Authorized Official Contact | 3037766872 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mark W. Hinman, Md, Llc 1350 Tulip St Longmont CO 80501-3140 Ph: (303) 776-6872 | Mark W. Hinman, Md, Llc 1350 Tulip St Longmont CO 80501-3140 Ph: (303) 776-6872 |
| NPI Number | 1992988828 |
|---|---|
| Provider Enumeration Date | 12/13/2007 |
| Last Update Date | 12/13/2007 |
| Medicare PECOS PAC ID | 1557356326 |
|---|---|
| Medicare Enrollment ID | O20040420000327 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1992988828 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 261QP2300X | Clinic/center - Primary Care | (* (Not Available)) | Primary |
| Provider Name | Mark Hinman |
|---|---|
| Provider Type | Practitioner - Family Practice |
| Provider Identifiers | NPI Number: 1750385415 PECOS PAC ID: 6507851375 Enrollment ID: I20040420000436 |
| Provider Name | Rhea Teasley-bennett |
|---|---|
| Provider Type | Practitioner - Nurse Practitioner |
| Provider Identifiers | NPI Number: 1427529197 PECOS PAC ID: 4486002243 Enrollment ID: I20231205000603 |
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