Provider Demographics
NPI:1376582916
Name:HINSON, CHRISTOPHER C (OD)
Entity Type:Individual
Prefix:
First Name:CHRISTOPHER
Middle Name:C
Last Name:HINSON
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4720 WATERS AVE
Mailing Address - Street 2:
Mailing Address - City:SAVANNAH
Mailing Address - State:GA
Mailing Address - Zip Code:31404-6292
Mailing Address - Country:US
Mailing Address - Phone:912-350-4811
Mailing Address - Fax:912-350-4821
Practice Address - Street 1:420 GENTILLY PL
Practice Address - Street 2:
Practice Address - City:STATESBORO
Practice Address - State:GA
Practice Address - Zip Code:30458-5144
Practice Address - Country:US
Practice Address - Phone:912-489-3606
Practice Address - Fax:912-489-1513
Is Sole Proprietor?:No
Enumeration Date:2006-06-06
Last Update Date:2017-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA001913152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
582023987006OtherCHAMPUS
GA579215606AMedicaid
004975OtherBLUE CROSS BLUE SHIELD
GA579215606AMedicaid
GA41ZCFKFMedicare ID - Type Unspecified