Provider Demographics
NPI:1619471182
Name:HINSON, KEVIN A (DO)
Entity Type:Individual
Prefix:DR
First Name:KEVIN
Middle Name:A
Last Name:HINSON
Suffix:
Gender:M
Credentials:DO
Other - Prefix:DR
Other - First Name:KEVIN
Other - Middle Name:ANDREW
Other - Last Name:HINSON
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:DO
Mailing Address - Street 1:200 CORPORATE BLVD
Mailing Address - Street 2:
Mailing Address - City:LAFAYETTE
Mailing Address - State:LA
Mailing Address - Zip Code:70508-3870
Mailing Address - Country:US
Mailing Address - Phone:800-893-9698
Mailing Address - Fax:
Practice Address - Street 1:350 HOSPITAL WAY STE 101
Practice Address - Street 2:
Practice Address - City:SOMERSET
Practice Address - State:KY
Practice Address - Zip Code:42503-1872
Practice Address - Country:US
Practice Address - Phone:606-451-5093
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-03-20
Last Update Date:2021-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY04847207P00000X
390200000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine