Individual
MS. MARILYN LYNNE HINES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
D.O.
Contact information
Practice address
1921 STONECIPHER DR, ADA, OK 74820
(580) 436-3980
Mailing address
1921 STONECIPHER DR, ADA, OK 74820-3439
(580) 436-3980
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
3113
OK
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
100221300F
—
OK
05
—
100708090C
—
OK
Enumeration date
08/01/2006
Last updated
06/13/2018
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