Provider Demographics
NPI:1104959972
Name:STEVEN D HINSHAW D O INC
Entity type:Organization
Organization Name:STEVEN D HINSHAW D O INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PHYSICIAN
Authorized Official - Prefix:DR
Authorized Official - First Name:STEVEN
Authorized Official - Middle Name:DONALD
Authorized Official - Last Name:HINSHAW
Authorized Official - Suffix:
Authorized Official - Credentials:DO
Authorized Official - Phone:580-228-3527
Mailing Address - Street 1:PO BOX 150
Mailing Address - Street 2:
Mailing Address - City:WAURIKA
Mailing Address - State:OK
Mailing Address - Zip Code:73573-0150
Mailing Address - Country:US
Mailing Address - Phone:580-228-3527
Mailing Address - Fax:580-228-2578
Practice Address - Street 1:110 W BROADWAY AVE
Practice Address - Street 2:
Practice Address - City:WAURIKA
Practice Address - State:OK
Practice Address - Zip Code:73573-2212
Practice Address - Country:US
Practice Address - Phone:580-228-3527
Practice Address - Fax:580-228-2578
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-13
Last Update Date:2008-12-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK2748207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily MedicineGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OKD17444Medicare UPIN
OK509502626Medicare ID - Type Unspecified