MEDICARE: HINSON FAMILY VISION

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	152W00000X	Optometrist	2081	WI

General Provider Information

NPI Number	:	1669706958
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	HINSON FAMILY VISION

Provider Business Mailing Address
First Line	:	12032 W PLAINFIELD AVE
Second Line	:
City	:	GREENFIELD
State	:	WI
Zip	:	53228-1857
Country	:	US
Telephone Number	:	414-543-0627
Fax Number	:	414-328-8030

Provider Business Practice Location Address
First Line	:	3049 S OAKES RD
Second Line	:
City	:	STURTEVANT
State	:	WI
Zip	:	53177-1961
Country	:	US
Telephone Number	:	262-598-8627
Fax Number	:	262-598-8629

Authorized Official
Title or Position	:	MEMBER
Name	:	DR. DOUGLAS M HINSON
Credential	:	OD
Telephone Number	:	414-543-0627

Provider Enumeration Date	:	09/21/2009
Last Update Date	:	09/21/2009

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Directions to “HINSON FAMILY VISION ” Practice Location

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