MEDICARE: DR. JOHN T. HANSBARGER M.D.

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	207Q00000X	Family Medicine Physician	20610	WV

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	VAA104451	OTHER	VA	GROUP PTAN
3	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1316922933
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JOHN T. HANSBARGER M.D.

Provider Business Mailing Address
First Line	:	PO BOX 590
Second Line	:
City	:	UNION
State	:	WV
Zip	:	24983-0590
Country	:	US
Telephone Number	:	304-772-3064
Fax Number	:	304-772-3296

Provider Business Practice Location Address
First Line	:	226 MARKET ST
Second Line	:
City	:	NEW CASTLE
State	:	VA
Zip	:	24127-6080
Country	:	US
Telephone Number	:	304-772-3064
Fax Number	:	304-772-3296

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	12/07/2005
Last Update Date	:	01/29/2025

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