Provider Demographics
NPI:1346286671
Name:HINSHAW, VINCENT W (DO)
Entity Type:Individual
Prefix:MR
First Name:VINCENT
Middle Name:W
Last Name:HINSHAW
Suffix:
Gender:M
Credentials:DO
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1105 E DIVISION ST
Mailing Address - Street 2:
Mailing Address - City:NEILLSVILLE
Mailing Address - State:WI
Mailing Address - Zip Code:54456-2122
Mailing Address - Country:US
Mailing Address - Phone:715-937-8500
Mailing Address - Fax:715-819-1045
Practice Address - Street 1:1105 E DIVISION ST
Practice Address - Street 2:
Practice Address - City:NEILLSVILLE
Practice Address - State:WI
Practice Address - Zip Code:54456-2122
Practice Address - Country:US
Practice Address - Phone:715-937-8500
Practice Address - Fax:715-819-1045
Is Sole Proprietor?:No
Enumeration Date:2006-06-22
Last Update Date:2024-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WI66323207Q00000X, 208M00000X
LA339749208M00000X
WY7057A207Q00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes207Q00000XAllopathic & Osteopathic PhysiciansFamily Medicine
No208M00000XAllopathic & Osteopathic PhysiciansHospitalist
Provider Identifiers
StateIdentifier IDID TypeIssuer
WY12028390Medicaid
WY12028390Medicaid
WY20031Medicare ID - Type UnspecifiedMEDICARE