Provider Demographics
NPI:1861287302
Name:HINSHAW, ELDON JEFFERY
Entity type:Individual
Prefix:
First Name:ELDON
Middle Name:JEFFERY
Last Name:HINSHAW
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1622 S ANN CT
Mailing Address - Street 2:
Mailing Address - City:INDEPENDENCE
Mailing Address - State:MO
Mailing Address - Zip Code:64057-1960
Mailing Address - Country:US
Mailing Address - Phone:573-424-1591
Mailing Address - Fax:
Practice Address - Street 1:1622 S ANN CT
Practice Address - Street 2:
Practice Address - City:INDEPENDENCE
Practice Address - State:MO
Practice Address - Zip Code:64057-1960
Practice Address - Country:US
Practice Address - Phone:573-424-1591
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-04-14
Last Update Date:2025-04-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician