Provider Demographics
NPI:1033857180
Name:HINTON, KAYLA (DO)
Entity type:Individual
Prefix:
First Name:KAYLA
Middle Name:
Last Name:HINTON
Suffix:
Gender:F
Credentials:DO
Other - Prefix:
Other - First Name:KAYLA
Other - Middle Name:ANN
Other - Last Name:YOB
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1620 MICHIGAN AVE STE 125
Mailing Address - Street 2:
Mailing Address - City:DETROIT
Mailing Address - State:MI
Mailing Address - Zip Code:48216-1493
Mailing Address - Country:US
Mailing Address - Phone:313-444-5630
Mailing Address - Fax:313-724-3773
Practice Address - Street 1:1620 MICHIGAN AVE STE 125
Practice Address - Street 2:
Practice Address - City:DETROIT
Practice Address - State:MI
Practice Address - Zip Code:48216-1493
Practice Address - Country:US
Practice Address - Phone:313-444-5630
Practice Address - Fax:313-724-3773
Is Sole Proprietor?:No
Enumeration Date:2022-05-26
Last Update Date:2025-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
390200000X
MI5101027993207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No390200000XStudent, Health CareStudent in an Organized Health Care Education/Training Program