Provider Demographics
NPI:1780792911
Name:HINDS, MARSHALL K (MD)
Entity type:Individual
Prefix:MR
First Name:MARSHALL
Middle Name:K
Last Name:HINDS
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 1:907 18TH ST E
Mailing Address - Street 2:SUITE 150
Mailing Address - City:TIFTON
Mailing Address - State:GA
Mailing Address - Zip Code:31794-3643
Mailing Address - Country:US
Mailing Address - Phone:229-896-8159
Mailing Address - Fax:
Practice Address - Street 1:706 N PARRISH AVE
Practice Address - Street 2:
Practice Address - City:ADEL
Practice Address - State:GA
Practice Address - Zip Code:31620-1511
Practice Address - Country:US
Practice Address - Phone:229-896-8159
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-08-28
Last Update Date:2015-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GA051662207P00000X, 207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207P00000XAllopathic & Osteopathic PhysiciansEmergency Medicine
No207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
Provider Identifiers
StateIdentifier IDID TypeIssuer
GA000955248JOtherGA MEDICAID ID FOR URGENTONE IN SAVANNAH
SCG46909OtherSC MEDICAID ID FOR URGENTONE
GA202I088189OtherGA MEDICARE ID FOR URGENTONE
GAP00394402OtherRR MEDICARE ID FOR URGENTONE
GA52002512-009OtherBCBS/GA ID FOR URGENTONE IN POOLER
SCGPA892OtherSC MEDICAID GROUP ID FOR URGENTONE IN POOLER
SCGPA902OtherSC MEDICAID GROUP ID FOR URGENTONE IN
GA000955248KOtherGA MEDICAID ID FOR URGENTONE IN POOLER
GA52002512-008OtherBCBS/GA ID FOR URGENTONE IN SAVANNAH
GACG4057OtherRR MEDICARE GROUP ID FOR URGENTONE
GAGRP2837OtherGA MEDICARE GROUP ID FOR URGENTONE
GA52002512-009OtherBCBS/GA ID FOR URGENTONE IN POOLER