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Individual

DR. RUSSELL WALKER HINERMAN

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
M.D.

Contact information

Practice address
220 HAWTHORNE PARK, ATHENS, GA 30606-2148
(706) 548-0500
(706) 548-3575
Mailing address
220 HAWTHORNE PARK, ATHENS, GA 30606
(706) 548-0500
(706) 548-3575

Taxonomy

Speciality
Code
Description
License number
State
2085R0001X
Radiation Oncology Physician
Primary
29468
GA
2085R0001X
Radiation Oncology Physician
ME54316
FL

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
000344286C
GA
05
2567024-00
FL
01
920006652
RAILROAD MEDICARE
FL
Enumeration date
04/01/2006
Last updated
11/05/2015
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