Provider Demographics
NPI:1518911247
Name:HINKLE, DEBORAH LEE (PHYSICIAN ASSISTANT)
Entity Type:Individual
Prefix:
First Name:DEBORAH
Middle Name:LEE
Last Name:HINKLE
Suffix:
Gender:F
Credentials:PHYSICIAN ASSISTANT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:308 ETON RD
Mailing Address - Street 2:
Mailing Address - City:SMYRNA
Mailing Address - State:TN
Mailing Address - Zip Code:37167-4203
Mailing Address - Country:US
Mailing Address - Phone:615-512-1092
Mailing Address - Fax:
Practice Address - Street 1:STONES RIVER HOSPITAL
Practice Address - Street 2:324 DOOLITTLE ROAD
Practice Address - City:WOODBURY
Practice Address - State:TN
Practice Address - Zip Code:37190-5041
Practice Address - Country:US
Practice Address - Phone:615-563-4001
Practice Address - Fax:
Is Sole Proprietor?:Not Answered
Enumeration Date:2006-05-19
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNPA0000000096363A00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes363A00000XPhysician Assistants & Advanced Practice Nursing ProvidersPhysician Assistant
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3665340Medicare ID - Type UnspecifiedPHYSICIAN ASSISTANT
TNR93282Medicare UPIN