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Organization

DANIEL K HINCKLEY MD PA

Active
Organization subpart
No

Provider details

NPI number
Authorized official
DR. DANIEL K HINCKLEY MD (PRESIDENT)
(208) 522-1764
Entity
Organization

Contact information

Practice address
2065 E 17TH ST, ST A, IDAHO FALLS, ID 83404-8042
(208) 522-1764
(208) 522-1766
Mailing address
2065 E 17TH ST, SUITE A, IDAHO FALLS, ID 83404-8042
(208) 522-1764
(208) 522-1766

Taxonomy

Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
M-5686
ID

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
002665500
ID
Enumeration date
12/01/2006
Last updated
12/10/2014
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