Kenneth Hines MD PA

NPI #1972689321 in Greenwood, Mississippi

Provider Information

NPI Number: 1972689321
Entity Type: Organization
Organization Name: Kenneth Hines MD PA
Primary Specialty: Internal Medicine
Enumeration Date: Oct 28, 2006
Last Updated: Nov 7, 2007

Practice Location

Address: 408 W MARKET ST
City: Greenwood
State: Mississippi
ZIP Code: 38930
Phone: (662) 455-1442

Authorized Official

Name: KENNETH LEE HINES, MD
Title: PRESIDENT 100 PERCENT STOCKHOLDER
Phone: (662) 455-1442

Specialties & Taxonomy Codes

Specialty	Taxonomy Code	Primary
Internal Medicine	207R00000X	Primary

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