Individual
JOHN L HINES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
5296 PETERS CREEK RD, ROANOKE, VA 24019-3808
(540) 855-5100
Mailing address
PO BOX 1789, ROANOKE, VA 24008-1789
(540) 855-5100
Taxonomy
Speciality
Code
Description
License number
State
207W00000X
Ophthalmology Physician
Primary
0101043707
VA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
006302289
—
VA
Enumeration date
06/16/2005
Last updated
02/04/2010
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