Individual
DR. ELBERT EDWIN HINES III
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
6263 POPLAR AVE, STE 1052, MEMPHIS, TN 38119-4736
(901) 761-6157
(901) 213-4513
Mailing address
6263 POPLAR AVE, STE 1052, MEMPHIS, TN 38119-4736
(901) 761-6157
(901) 761-4145
Taxonomy
Speciality
Code
Description
License number
State
207QG0300X
Geriatric Medicine (Family Medicine) Physician
Primary
MD15653
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
080040881
RAILROAD MEDICARE
TN
01
—
2008944
BLUECROSS&BLUESHIELD
TN
05
—
3017714
—
TN
Enumeration date
07/29/2005
Last updated
05/06/2016
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