Individual
DR. WAYNE GENE HINES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
O.D.
Contact information
Practice address
14120 COMMERCE AVE NE, SUITE 100, PRIOR LAKE, MN 55372-1500
(952) 447-2020
(952) 447-2322
Mailing address
5270 SAINT ALBANS BAY RD, EXCELSIOR, MN 55331-8635
(952) 474-2654
(952) 474-2654
Taxonomy
Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
0001425
MN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0314340001
ADMINISTAR
MN
01
—
1014529
PREFERRED ONE
MN
01
—
2123989
MEDICA DISPENSING
MN
01
—
2223987
UINTED HEALTHCARE
MN
01
—
87852HI
BCBSMN
MN
01
—
HP15419
HEALTHPARTNERS
MN
Enumeration date
01/31/2007
Last updated
07/09/2007
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