Provider Demographics
NPI:1902924368
Name:EYE SPECIALISTS OF WEST COUNTY, P.C.
Entity type:Organization
Organization Name:EYE SPECIALISTS OF WEST COUNTY, P.C.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:KEVIN
Authorized Official - Middle Name:D
Authorized Official - Last Name:HINSHAW
Authorized Official - Suffix:
Authorized Official - Credentials:MD
Authorized Official - Phone:314-604-4716
Mailing Address - Street 1:2704 MARTINGALE DR
Mailing Address - Street 2:
Mailing Address - City:BERTHOUD
Mailing Address - State:CO
Mailing Address - Zip Code:80513-8418
Mailing Address - Country:US
Mailing Address - Phone:314-604-4716
Mailing Address - Fax:
Practice Address - Street 1:2704 MARTINGALE DR
Practice Address - Street 2:
Practice Address - City:BERTHOUD
Practice Address - State:CO
Practice Address - Zip Code:80513-8418
Practice Address - Country:US
Practice Address - Phone:314-604-4716
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-03-26
Last Update Date:2021-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MO109644207W00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes207W00000XAllopathic & Osteopathic PhysiciansOphthalmologyGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
MO000013717Medicare PIN
MOG32704Medicare UPIN