Provider Demographics
NPI:1639539828
Name:HINDS, GREGORY OWEN (DPH)
Entity Type:Individual
Prefix:MR
First Name:GREGORY
Middle Name:OWEN
Last Name:HINDS
Suffix:
Gender:M
Credentials:DPH
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2323 N HARRISON ST
Mailing Address - Street 2:
Mailing Address - City:SHAWNEE
Mailing Address - State:OK
Mailing Address - Zip Code:74804-3134
Mailing Address - Country:US
Mailing Address - Phone:405-275-2355
Mailing Address - Fax:847-396-3264
Practice Address - Street 1:2323 N HARRISON ST
Practice Address - Street 2:
Practice Address - City:SHAWNEE
Practice Address - State:OK
Practice Address - Zip Code:74804-3134
Practice Address - Country:US
Practice Address - Phone:405-275-2355
Practice Address - Fax:847-396-3264
Is Sole Proprietor?:No
Enumeration Date:2016-03-01
Last Update Date:2016-03-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK9032183500000X
TX22166183500000X
NMRP00004025183500000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes183500000XPharmacy Service ProvidersPharmacist