Provider Demographics
NPI:1023279130
Name:HINTON, JOSEPH BRYAN (MD)
Entity type:Individual
Prefix:
First Name:JOSEPH
Middle Name:BRYAN
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 1:250 N SHADELAND AVE
Mailing Address - Street 2:
Mailing Address - City:INDIANAPOLIS
Mailing Address - State:IN
Mailing Address - Zip Code:46219-4959
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:4725 STATESMEN DR
Practice Address - Street 2:STE. C-D
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46250-5644
Practice Address - Country:US
Practice Address - Phone:317-577-4200
Practice Address - Fax:800-731-0751
Is Sole Proprietor?:No
Enumeration Date:2008-06-20
Last Update Date:2024-12-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN01072484A207LP3000X, 207L00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207L00000XAllopathic & Osteopathic PhysiciansAnesthesiology
No207LP3000XAllopathic & Osteopathic PhysiciansAnesthesiologyPediatric Anesthesiology
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN201162950Medicaid
INQ00265953OtherRAILROAD PTAN
INQ00265953OtherRAILROAD PTAN