Provider Demographics
NPI:1649684879
Name:HINTON, COURTNEY HUDSON (DO)
Entity type:Individual
Prefix:DR
First Name:COURTNEY
Middle Name:HUDSON
Last Name:HINTON
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:COURTNEY
Other - Middle Name:
Other - Last Name:HUDSON
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1964 S MAIN ST
Mailing Address - Street 2:
Mailing Address - City:WAKE FOREST
Mailing Address - State:NC
Mailing Address - Zip Code:27587-9336
Mailing Address - Country:US
Mailing Address - Phone:919-554-0177
Mailing Address - Fax:919-554-9277
Practice Address - Street 1:1964 S MAIN ST
Practice Address - Street 2:
Practice Address - City:WAKE FOREST
Practice Address - State:NC
Practice Address - Zip Code:27587-9336
Practice Address - Country:US
Practice Address - Phone:919-554-0177
Practice Address - Fax:919-554-9277
Is Sole Proprietor?:No
Enumeration Date:2014-06-16
Last Update Date:2017-12-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC2017-00862207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine