NPIMap

Organization Active NPI

M R Hinckley MD PLLC

  • MOHS-Micrographic Surgery Physician
  • Midvale, UT
National Provider Identifier
1902171895
Registry record updated Mar 12, 2012
On this page

Key facts

NPPES NPI Registry
Primary specialty
MOHS-Micrographic Surgery PhysicianTaxonomy code 207ND0101X
License
76133041205 Issued in UT
Legal business name
M R HINCKLEY MD PLLC
Practice address
602 Fort Union Blvd
2ND Floor
Midvale, UT 84047-2216
Phone
(801) 313-1010
Fax
(801) 747-2116
NPI assigned
Mar 12, 2012
Last updated
Mar 12, 2012By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 12, 2012

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name
Michael Richard Hinckley, MD
Title
Owner
Phone
(801) 313-1010

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
MOHS-Micrographic Surgery Physician 207ND0101X 76133041205 UT Primary

Addresses

Primary practice location

602 Fort Union Blvd
2ND Floor
Midvale, UT 84047-2216

Mailing address

602 Fort Union Blvd
2ND Floor
Midvale, UT 84047-2216
Phone (801) 313-1010

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 8

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1331510400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1331510400000",
    "number": "1902171895",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "602 FORT UNION BLVD",
            "address_2": "2ND FLOOR",
            "city": "MIDVALE",
            "state": "UT",
            "postal_code": "840472216",
            "telephone_number": "801-313-1010",
            "fax_number": "801-747-2116"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "602 FORT UNION BLVD",
            "address_2": "2ND FLOOR",
            "city": "MIDVALE",
            "state": "UT",
            "postal_code": "840472216",
            "telephone_number": "801-313-1010",
            "fax_number": "801-747-2116"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "M R HINCKLEY MD PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2012-03-12",
        "last_updated": "2012-03-12",
        "status": "A",
        "authorized_official_last_name": "HINCKLEY",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "RICHARD",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "801-313-1010",
        "authorized_official_credential": "MD"
    },
    "taxonomies": [
        {
            "code": "207ND0101X",
            "taxonomy_group": "",
            "desc": "Dermatology, MOHS-Micrographic Surgery",
            "state": "UT",
            "license": "76133041205",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Midvale, UT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 12, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.