Provider Demographics
NPI:1043795123
Name:HINTON, DANIEL WAYNE (PHARMD)
Entity Type:Individual
Prefix:
First Name:DANIEL
Middle Name:WAYNE
Last Name:HINTON
Suffix:
Gender:M
Credentials:PHARMD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:111 ALCORN DR
Mailing Address - Street 2:
Mailing Address - City:CORINTH
Mailing Address - State:MS
Mailing Address - Zip Code:38834-9359
Mailing Address - Country:US
Mailing Address - Phone:662-286-6991
Mailing Address - Fax:662-287-6280
Practice Address - Street 1:111 ALCORN DR
Practice Address - Street 2:
Practice Address - City:CORINTH
Practice Address - State:MS
Practice Address - Zip Code:38834-9359
Practice Address - Country:US
Practice Address - Phone:662-286-6991
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-09-25
Last Update Date:2018-09-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MSE-010759183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist