Provider Demographics
NPI:1770559585
Name:HINKLE, MARY E (MD)
Entity type:Individual
Prefix:
First Name:MARY
Middle Name:E
Last Name:HINKLE
Suffix:
Gender:F
Credentials:MD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11595 N MERIDIAN ST STE 375
Mailing Address - Street 2:
Mailing Address - City:CARMEL
Mailing Address - State:IN
Mailing Address - Zip Code:46032-3950
Mailing Address - Country:US
Mailing Address - Phone:317-575-7300
Mailing Address - Fax:317-575-7333
Practice Address - Street 1:8111 TOWNSHIP LINE RD
Practice Address - Street 2:
Practice Address - City:INDIANAPOLIS
Practice Address - State:IN
Practice Address - Zip Code:46260-2479
Practice Address - Country:US
Practice Address - Phone:317-575-7300
Practice Address - Fax:317-575-7333
Is Sole Proprietor?:No
Enumeration Date:2006-02-23
Last Update Date:2018-03-17
Deactivation Date:2014-11-12
Deactivation Code:
Reactivation Date:2017-10-25
Provider Licenses
StateLicense IDTaxonomies
IN01029471A208M00000X, 207V00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207V00000XAllopathic & Osteopathic PhysiciansObstetrics & Gynecology
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
IN300008266Medicaid
IN160020858Medicare PIN
IN677690DDMedicare PIN
INB29761Medicare UPIN