Provider Demographics
NPI:1568409738
Name:HINGSBERGEN, DOUGLAS C (MD FACS)
Entity Type:Individual
Prefix:MR
First Name:DOUGLAS
Middle Name:C
Last Name:HINGSBERGEN
Suffix:
Gender:M
Credentials:MD FACS
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25 OFFICE PARK DR
Mailing Address - Street 2:
Mailing Address - City:HAMILTON
Mailing Address - State:OH
Mailing Address - Zip Code:45013
Mailing Address - Country:US
Mailing Address - Phone:513-844-1000
Mailing Address - Fax:513-896-3727
Practice Address - Street 1:25 OFFICE PARK DR
Practice Address - Street 2:
Practice Address - City:HAMILTON
Practice Address - State:OH
Practice Address - Zip Code:45013
Practice Address - Country:US
Practice Address - Phone:513-844-1000
Practice Address - Fax:513-896-3727
Is Sole Proprietor?:No
Enumeration Date:2006-05-31
Last Update Date:2011-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH35052940208600000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes208600000XAllopathic & Osteopathic PhysiciansSurgery
Provider Identifiers
StateIdentifier IDID TypeIssuer
0644346OtherAETNA
OH0705580Medicaid
000000021034OtherANTHEM
KY64099203Medicaid
020033049OtherRAILROAD MEDICARE
222638OtherAMERIGROUP
311474851028OtherCARESOURCE
5294005OtherHUMANA CHOICE CARE
5294006OtherHUMANA CHOICE CARE
1700904OtherUNITED HEALTHCARE
311474851OtherHUMANA
1700904OtherUNITED HEALTHCARE
222638OtherAMERIGROUP