Provider Demographics
NPI:1275992299
Name:HINES, DONALD ANTHONY (HHP, DD)
Entity Type:Individual
Prefix:
First Name:DONALD
Middle Name:ANTHONY
Last Name:HINES
Suffix:
Gender:M
Credentials:HHP, DD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5201 S CHUICHU RD
Mailing Address - Street 2:LOT 18
Mailing Address - City:CASA GRANDE
Mailing Address - State:AZ
Mailing Address - Zip Code:85193-7717
Mailing Address - Country:US
Mailing Address - Phone:520-280-2371
Mailing Address - Fax:
Practice Address - Street 1:5201 S CHUICHU RD
Practice Address - Street 2:LOT 18
Practice Address - City:CASA GRANDE
Practice Address - State:AZ
Practice Address - Zip Code:85193-7717
Practice Address - Country:US
Practice Address - Phone:520-280-2371
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-02-18
Last Update Date:2016-02-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program