Basic Information
| Provider Information | |||||||||
| NPI: | 1811064009 | ||||||||
| EntityType: | 1 | ||||||||
| ReplacementNPI: | |||||||||
| OrganizationName: | |||||||||
| LastName: | HINKLE | ||||||||
| FirstName: | GREGORY | ||||||||
| MiddleName: | A | ||||||||
| NamePrefix: | DR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | PH.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 213 MIDDLEBURY ST | ||||||||
| Address2: | |||||||||
| City: | GOSHEN | ||||||||
| State: | IN | ||||||||
| PostalCode: | 465282956 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5745343300 | ||||||||
| FaxNumber: | 5745345412 | ||||||||
| Practice Location | |||||||||
| Address1: | 213 MIDDLEBURY ST | ||||||||
| Address2: | |||||||||
| City: | GOSHEN | ||||||||
| State: | IN | ||||||||
| PostalCode: | 465282956 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5745343300 | ||||||||
| FaxNumber: | 5745345412 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 11/30/2006 | ||||||||
| LastUpdateDate: | 12/31/2020 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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| NPICertificationDate: | 12/31/2020 | ||||||||
Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 103T00000X | 20040825A | IN | Y | Behavioral Health & Social Service Providers | Psychologist |
No ID Information.