Provider Demographics
NPI:1356349369
Name:HINES, WILLIAM L (MD)
Entity type:Individual
Prefix:
First Name:WILLIAM
Middle Name:L
Last Name:HINES
Suffix:
Gender:M
Credentials:MD
Other - Prefix:
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Mailing Address - Street 1:2480 S DOWNING ST
Mailing Address - Street 2: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: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
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-13
Last Update Date:2008-04-10
Deactivation Date:
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Provider Licenses
StateLicense IDTaxonomies
CO19133207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmology
Provider Identifiers
StateIdentifier IDID TypeIssuer
CO01191337Medicaid
CO01191337Medicaid
COD28063Medicare UPIN