Provider Demographics
NPI:1821194150
Name:WILLIAM L. HINES, M.D., P.C.
Entity Type:Organization
Organization Name:WILLIAM L. HINES, M.D., P.C.
Other - Org Name:HINES-SIGHT
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGING DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:CHARLIE
Authorized Official - Middle Name:
Authorized Official - Last Name:GOETZ
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:303-777-3277
Mailing Address - Street 1:2480 S DOWNING ST
Mailing Address - Street 2:SUITE G-30
Mailing Address - City:DENVER
Mailing Address - State:CO
Mailing Address - Zip Code:80210-5890
Mailing Address - Country:US
Mailing Address - Phone:303-777-3277
Mailing Address - Fax:303-698-9713
Practice Address - Street 1:2480 S DOWNING ST
Practice Address - Street 2:SUITE G-30
Practice Address - City:DENVER
Practice Address - State:CO
Practice Address - Zip Code:80210-5890
Practice Address - Country:US
Practice Address - Phone:303-777-3277
Practice Address - Fax:303-698-9713
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-09-15
Last Update Date:2017-04-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO19133174400000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes174400000XOther Service ProvidersSpecialistGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
COCE4308Medicare PIN
COCE4308Medicare PIN