Provider Demographics
NPI:1336160886
Name:HINKLE, STEPHEN W (OD)
Entity Type:Individual
Prefix:DR
First Name:STEPHEN
Middle Name:W
Last Name:HINKLE
Suffix:
Gender:M
Credentials:OD
Other - Prefix:
Other - First Name:
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Mailing Address - Street 1:8833 WESTERN HEMLOCK WAY
Mailing Address - Street 2:
Mailing Address - City:LORTON
Mailing Address - State:VA
Mailing Address - Zip Code:22079-5677
Mailing Address - Country:US
Mailing Address - Phone:703-646-5526
Mailing Address - Fax:
Practice Address - Street 1:44075 PIPELINE PLZ
Practice Address - Street 2:SUITE 205
Practice Address - City:ASHBURN
Practice Address - State:VA
Practice Address - Zip Code:20147-5881
Practice Address - Country:US
Practice Address - Phone:703-724-9948
Practice Address - Fax:703-724-9948
Is Sole Proprietor?:No
Enumeration Date:2006-07-21
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA0618001162152W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes152W00000XEye and Vision Services ProvidersOptometrist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA0618001162OtherSTATE LICENSE
VA0618001162OtherSTATE LICENSE
VA0618001162OtherSTATE LICENSE
VAMH1231531OtherDEA