Organization
KENNETH HINES MD PA
Active
Organization subpart
No
Provider details
NPI number
Authorized official
KENNETH LEE HINES MD (PRESIDENT 100 PERCENT STOCKHOLDER)
(662) 455-1442
Entity
Organization
Contact information
Practice address
408 W MARKET ST, GREENWOOD, MS 38930
(662) 455-1442
(662) 455-6065
Mailing address
408 W MARKET ST, GREENWOOD, MS 38930
(662) 455-1442
(662) 455-6065
Taxonomy
Speciality
Code
Description
License number
State
207R00000X
Internal Medicine Physician
Primary
08354
MS
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
09016211
—
MS
Enumeration date
10/28/2006
Last updated
11/07/2007
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