Provider Demographics
NPI:1669441341
Name:HINTON, JEFFREY TAYLOR (MD)
Entity Type:Individual
Prefix:
First Name:JEFFREY
Middle Name:TAYLOR
Last Name:HINTON
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1500 W ELK AVE STE 21
Mailing Address - Street 2:
Mailing Address - City:ELIZABETHTON
Mailing Address - State:TN
Mailing Address - Zip Code:37643-2654
Mailing Address - Country:US
Mailing Address - Phone:423-543-2584
Mailing Address - Fax:423-722-2060
Practice Address - Street 1:2 PROFESSIONAL PARK DR
Practice Address - Street 2:SUITE 21
Practice Address - City:JOHNSON CITY
Practice Address - State:TN
Practice Address - Zip Code:37604-6583
Practice Address - Country:US
Practice Address - Phone:423-926-8813
Practice Address - Fax:423-926-8910
Is Sole Proprietor?:No
Enumeration Date:2006-03-16
Last Update Date:2020-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TNMD25883207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
Provider Identifiers
StateIdentifier IDID TypeIssuer
TN3096354Medicaid
NC7905372Medicaid
TN3718898Medicaid
TNTN0102OtherJOHN DEERE INSURANCE CO
TN3718898Medicaid
TN3096357Medicare PIN