Provider Demographics
NPI:1194826610
Name:HINES, STEVEN R (DC)
Entity Type:Individual
Prefix:
First Name:STEVEN
Middle Name:R
Last Name:HINES
Suffix:
Gender:M
Credentials:DC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:305 N 24TH ST
Mailing Address - Street 2:
Mailing Address - City:ROGERS
Mailing Address - State:AR
Mailing Address - Zip Code:72756-3294
Mailing Address - Country:US
Mailing Address - Phone:479-636-3021
Mailing Address - Fax:479-636-9171
Practice Address - Street 1:305 N 24TH ST
Practice Address - Street 2:
Practice Address - City:ROGERS
Practice Address - State:AR
Practice Address - Zip Code:72756-3294
Practice Address - Country:US
Practice Address - Phone:479-636-3021
Practice Address - Fax:479-636-9171
Is Sole Proprietor?:No
Enumeration Date:2006-09-26
Last Update Date:2007-11-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AR982111N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes111N00000XChiropractic ProvidersChiropractor
Provider Identifiers
StateIdentifier IDID TypeIssuer
AR59371Medicare PIN