Provider Demographics
NPI:1922237361
Name:HINKLE, MARCUS LOGAN (DPT)
Entity Type:Individual
Prefix:DR
First Name:MARCUS
Middle Name:LOGAN
Last Name:HINKLE
Suffix:
Gender:M
Credentials:DPT
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Mailing Address - Street 1:75 EXECUTIVE DR STE C
Mailing Address - Street 2:
Mailing Address - City:CARMEL
Mailing Address - State:IN
Mailing Address - Zip Code:46032-2993
Mailing Address - Country:US
Mailing Address - Phone:317-900-9691
Mailing Address - Fax:317-912-1323
Practice Address - Street 1:14540 PRAIRIE LAKES BLVD N
Practice Address - Street 2:STE 103
Practice Address - City:NOBLESVILLE
Practice Address - State:IN
Practice Address - Zip Code:46060-4366
Practice Address - Country:US
Practice Address - Phone:770-778-3526
Practice Address - Fax:317-912-1323
Is Sole Proprietor?:Yes
Enumeration Date:2009-07-07
Last Update Date:2023-01-19
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
IN05011284A2251X0800X
GAPT009666225100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes2251X0800XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical TherapistOrthopedic
No225100000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersPhysical Therapist