Provider Demographics
NPI:1548741887
Name:HINKLE, GARY II
Entity Type:Individual
Prefix:
First Name:GARY
Middle Name:
Last Name:HINKLE
Suffix:II
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2902 IVY BRIDGE RD
Mailing Address - Street 2:
Mailing Address - City:FORT WASHINGTON
Mailing Address - State:MD
Mailing Address - Zip Code:20744-2139
Mailing Address - Country:US
Mailing Address - Phone:202-823-3591
Mailing Address - Fax:
Practice Address - Street 1:2902 IVY BRIDGE RD
Practice Address - Street 2:
Practice Address - City:FORT WASHINGTON
Practice Address - State:MD
Practice Address - Zip Code:20744-2139
Practice Address - Country:US
Practice Address - Phone:202-823-3591
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-24
Last Update Date:2018-08-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DC374U00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes374U00000XNursing Service Related ProvidersHome Health Aide