Basic Information
| Provider Information | |||||||||
| NPI: | 1568409738 | ||||||||
| EntityType: | 1 | ||||||||
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| OrganizationName: | |||||||||
| LastName: | HINGSBERGEN | ||||||||
| FirstName: | DOUGLAS | ||||||||
| MiddleName: | C | ||||||||
| NamePrefix: | MR. | ||||||||
| NameSuffix: | |||||||||
| Credential: | MD FACS | ||||||||
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| Mailing Information | |||||||||
| Address1: | 25 OFFICE PARK DR | ||||||||
| Address2: | |||||||||
| City: | HAMILTON | ||||||||
| State: | OH | ||||||||
| PostalCode: | 45013 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5138441000 | ||||||||
| FaxNumber: | 5138963727 | ||||||||
| Practice Location | |||||||||
| Address1: | 25 OFFICE PARK DR | ||||||||
| Address2: | |||||||||
| City: | HAMILTON | ||||||||
| State: | OH | ||||||||
| PostalCode: | 45013 | ||||||||
| CountryCode: | US | ||||||||
| TelephoneNumber: | 5138441000 | ||||||||
| FaxNumber: | 5138963727 | ||||||||
| Other Information | |||||||||
| ProviderEnumerationDate: | 05/31/2006 | ||||||||
| LastUpdateDate: | 04/19/2011 | ||||||||
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| ProviderGenderCode: | M | ||||||||
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| IsSoleProprietor: | N | ||||||||
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Taxonomy Information
| Taxonomy | License | State | Switch | TaxonomyGroup | TaxonomyType | TaxonomyClass | SubSpecialty | 208600000X | 35052940 | OH | Y | Allopathic & Osteopathic Physicians | Surgery |
ID Information
| ID | Type | State | Issuer | Description | 0644346 | 01 | AETNA | OTHER | 0705580 | 05 | OH | MEDICAID | 000000021034 | 01 | ANTHEM | OTHER | 64099203 | 05 | KY | MEDICAID | 020033049 | 01 | RAILROAD MEDICARE | OTHER | 222638 | 01 | AMERIGROUP | OTHER | 311474851028 | 01 | CARESOURCE | OTHER | 5294005 | 01 | HUMANA CHOICE CARE | OTHER | 5294006 | 01 | HUMANA CHOICE CARE | OTHER | 1700904 | 01 | UNITED HEALTHCARE | OTHER | 311474851 | 01 | HUMANA | OTHER |