Basic Information
| Provider Information | |||||||||
| NPI: | 1861498230 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | HINSON | ||||||||
| FirstName: | PATRICIA | ||||||||
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| Credential: | M.D. | ||||||||
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| Mailing Information | |||||||||
| Address1: | 416 MCCRAE STREET | ||||||||
| Address2: | |||||||||
| City: | GRIFTON | ||||||||
| State: | NC | ||||||||
| PostalCode: | 28530 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2525244463 | ||||||||
| FaxNumber: | 2525240681 | ||||||||
| Practice Location | |||||||||
| Address1: | 1850 W ARLINGTON BLVD | ||||||||
| Address2: | |||||||||
| City: | GREENVILLE | ||||||||
| State: | NC | ||||||||
| PostalCode: | 278345704 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 2527526101 | ||||||||
| FaxNumber: | 2527587781 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 06/21/2005 | ||||||||
| LastUpdateDate: | 10/09/2014 | ||||||||
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| ProviderGenderCode: | F | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 207R00000X | 2001376 | NC | Y | Allopathic & Osteopathic Physicians | Internal Medicine |
ID Information
| ID | Type | State | Issuer | Description | 89129GW | 05 | NC | MEDICAID |