Provider Demographics
NPI:1144741752
Name:HINTON, KATLYN R (ATC)
Entity Type:Individual
Prefix:
First Name:KATLYN
Middle Name:R
Last Name:HINTON
Suffix:
Gender:F
Credentials:ATC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1375 COMPANION CT APT 206
Mailing Address - Street 2:
Mailing Address - City:SUMTER
Mailing Address - State:SC
Mailing Address - Zip Code:29150-1755
Mailing Address - Country:US
Mailing Address - Phone:919-631-4967
Mailing Address - Fax:
Practice Address - Street 1:2000 OSWEGO HWY
Practice Address - Street 2:
Practice Address - City:SUMTER
Practice Address - State:SC
Practice Address - Zip Code:29153-7651
Practice Address - Country:US
Practice Address - Phone:803-469-2000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-07-05
Last Update Date:2017-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC2000024136207PS0010X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207PS0010XAllopathic & Osteopathic PhysiciansEmergency MedicineSports Medicine