Provider Demographics
NPI:1497717722
Name:HINKEBEIN, JAMES ROBIN (PT)
Entity Type:Individual
Prefix:
First Name:JAMES
Middle Name:ROBIN
Last Name:HINKEBEIN
Suffix:
Gender:M
Credentials:PT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:875 PENNSYLVANIA AVE
Mailing Address - Street 2:SUITE A
Mailing Address - City:BARDSTOWN
Mailing Address - State:KY
Mailing Address - Zip Code:40004-2529
Mailing Address - Country:US
Mailing Address - Phone:502-349-6961
Mailing Address - Fax:502-348-1789
Practice Address - Street 1:875 PENNSYLVANIA AVE
Practice Address - Street 2:SUITE A
Practice Address - City:BARDSTOWN
Practice Address - State:KY
Practice Address - Zip Code:40004-2529
Practice Address - Country:US
Practice Address - Phone:502-349-6961
Practice Address - Fax:502-348-1789
Is Sole Proprietor?:No
Enumeration Date:2006-04-03
Last Update Date:2010-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY003082225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
0726708Medicare ID - Type Unspecified