Individual
DR. MARK WALLACE HINMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
1350 TULIP ST, LONGMONT, CO 80501-3140
(303) 776-6872
(303) 776-2501
Mailing address
1350 TULIP ST, LONGMONT, CO 80501-3140
(303) 776-6872
(303) 776-2501
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
28820
CO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
04021093
—
CO
Enumeration date
06/10/2005
Last updated
01/19/2013
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