Provider Demographics
NPI:1356322796
Name:HINTERKOPF, HANS P (PA)
Entity Type:Individual
Prefix:MR
First Name:HANS
Middle Name:P
Last Name:HINTERKOPF
Suffix:
Gender:M
Credentials:PA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:117 N MAIN ST
Mailing Address - Street 2:
Mailing Address - City:DICKSON
Mailing Address - State:TN
Mailing Address - Zip Code:37055-1836
Mailing Address - Country:US
Mailing Address - Phone:931-623-4203
Mailing Address - Fax:931-650-3697
Practice Address - Street 1:117 N MAIN ST
Practice Address - Street 2:
Practice Address - City:DICKSON
Practice Address - State:TN
Practice Address - Zip Code:37055-1836
Practice Address - Country:US
Practice Address - Phone:931-623-4203
Practice Address - Fax:931-650-3697
Is Sole Proprietor?:No
Enumeration Date:2005-11-11
Last Update Date:2020-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNPA3207363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant