Individual
JAMES R HINES
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
PA
Contact information
Practice address
300 W MAY ST, MARENGO, IA 52301-1261
(319) 642-5543
(319) 642-8007
Mailing address
300 W MAY ST, MARENGO, IA 52301-1261
(319) 642-5543
(319) 642-8007
Taxonomy
Speciality
Code
Description
License number
State
363A00000X
Physician Assistant
Primary
001401
IA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
001401
PHYSICIAN ASSISTANT LICEN
IA
Enumeration date
01/29/2007
Last updated
07/08/2007
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