MEDICARE: MR. STANLEY DEAN HANSON O.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	152W00000X	Optometrist	899	CO

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

General Provider Information

NPI Number	:	1417949181
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MR. STANLEY DEAN HANSON O.D.

Provider Business Mailing Address
First Line	:	850 E HARVARD AVE
Second Line	:	SUITE 205
City	:	DENVER
State	:	CO
Zip	:	80210-5073
Country	:	US
Telephone Number	:	303-777-8551
Fax Number	:	303-777-8435

Provider Business Practice Location Address
First Line	:	850 E HARVARD AVE
Second Line	:	SUITE 205
City	:	DENVER
State	:	CO
Zip	:	80210-5073
Country	:	US
Telephone Number	:	303-777-8551
Fax Number	:	303-777-8435

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

Provider Enumeration Date	:	08/18/2005
Last Update Date	:	05/19/2009

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