Provider Demographics
NPI:1093802217
Name:DR. CARL HINTON, M.D., P.S.C.
Entity Type:Organization
Organization Name:DR. CARL HINTON, M.D., P.S.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:DR
Authorized Official - First Name:CARL
Authorized Official - Middle Name:BRUCE
Authorized Official - Last Name:HINTON
Authorized Official - Suffix:
Authorized Official - Credentials:MD, PSC
Authorized Official - Phone:270-365-9993
Mailing Address - Street 1:407 US HIGHWAY 62 W
Mailing Address - Street 2:PO BOX 418
Mailing Address - City:PRINCETON
Mailing Address - State:KY
Mailing Address - Zip Code:42445-2409
Mailing Address - Country:US
Mailing Address - Phone:270-365-9993
Mailing Address - Fax:270-365-0533
Practice Address - Street 1:407 US HIGHWAY 62 W
Practice Address - Street 2:
Practice Address - City:PRINCETON
Practice Address - State:KY
Practice Address - Zip Code:42445-2409
Practice Address - Country:US
Practice Address - Phone:270-365-9993
Practice Address - Fax:270-365-0533
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-10-09
Last Update Date:2013-02-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY31827208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes208600000XAllopathic & Osteopathic PhysiciansSurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
KY5478175OtherAETNA
KY64318272Medicaid
KYDB5026OtherRR MCR
KY000000334665OtherBLUE CROSS BLUE SHIELD
KY64318272Medicaid
KY000000334665OtherBLUE CROSS BLUE SHIELD