Provider Demographics
NPI:1609516384
Name:HINTON, CALEB JATRELL (RMA, RPT)
Entity Type:Individual
Prefix:
First Name:CALEB
Middle Name:JATRELL
Last Name:HINTON
Suffix:
Gender:M
Credentials:RMA, RPT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:51 MCSWAIN COMMUNITY RD
Mailing Address - Street 2:
Mailing Address - City:RICHTON
Mailing Address - State:MS
Mailing Address - Zip Code:39476-9541
Mailing Address - Country:US
Mailing Address - Phone:601-596-7153
Mailing Address - Fax:682-292-2158
Practice Address - Street 1:51 MCSWAIN COMMUNITY RD
Practice Address - Street 2:
Practice Address - City:RICHTON
Practice Address - State:MS
Practice Address - Zip Code:39476-9541
Practice Address - Country:US
Practice Address - Phone:601-596-7153
Practice Address - Fax:682-292-2158
Is Sole Proprietor?:Yes
Enumeration Date:2022-03-30
Last Update Date:2022-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MS251280246RP1900X
MS25D2250721247ZC0005X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes247ZC0005XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyClinical Laboratory Director, Non-physician
No246RP1900XTechnologists, Technicians & Other Technical Service ProvidersTechnician, PathologyPhlebotomy