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Individual

DR. RONALD WAYNE HINES

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
DPM

Contact information

Practice address
4513 W 124TH LN, LEAWOOD, KS 66209-2603
(405) 659-1842
(913) 261-9255
Mailing address
4513 W 124TH LN, LEAWOOD, KS 66209-2603
(405) 659-1842
(913) 261-9255

Taxonomy

Speciality
Code
Description
License number
State
213E00000X
Podiatrist
Primary
12-00387
KS
213E00000X
Podiatrist
2012014963
MO
213ES0103X
Foot & Ankle Surgery Podiatrist
113
OK

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
0764240001
DMERC
OK
01
1295773398
GROUP NPI
OK
01
731130289001
BLUE CROSS BLUE SHIELD
OK
Enumeration date
05/27/2005
Last updated
04/11/2013
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