Organization
E E HINES III MD, PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
DR. ELBERT E. HINES III M.D. (PRESIDENT)
(901) 761-6157
Entity
Organization
Contact information
Practice address
6263 POPLAR AVE, STE 1052, MEMPHIS, TN 38119-4701
(901) 761-6157
(901) 761-4145
Mailing address
3665 ELLEN DAVIES CV, BARTLETT, TN 38133-0940
(901) 849-7065
(901) 213-4513
Taxonomy
Speciality
Code
Description
License number
State
207QG0300X
Geriatric Medicine (Family Medicine) Physician
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
002008944
BLUE CROSS BLUE SHIELD
—
05
—
3389063
—
TN
01
—
4409209005
CIGNA
—
01
—
CL0583
RAILROAD MEDICARE
TN
Enumeration date
02/19/2007
Last updated
02/11/2015
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