Individual
PETER A HINCKLE
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
600 NE AVALON PL, CORVALLIS, OR 97330-9258
(541) 745-5053
(503) 391-7422
Mailing address
600 NE AVALON PL, CORVALLIS, OR 97330-9258
(541) 745-5053
(503) 391-7422
Taxonomy
Speciality
Code
Description
License number
State
174400000X
Specialist
Primary
MD18129
OR
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
057443
—
OR
Enumeration date
08/31/2006
Last updated
02/23/2021
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