MEDICARE: DR. JAMES EDWARD HANSEN MD

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	207RC0000X	Cardiovascular Disease Physician	MD28010	OR

General Provider Information

NPI Number	:	1528071131
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. JAMES EDWARD HANSEN MD

Provider Business Mailing Address
First Line	:	20 FALLING LEAF LN
Second Line	:
City	:	EAGLE POINT
State	:	OR
Zip	:	97524-8606
Country	:	US
Telephone Number	:	541-826-5576
Fax Number	:

Provider Business Practice Location Address
First Line	:	20 FALLING LEAF LN
Second Line	:
City	:	EAGLE POINT
State	:	OR
Zip	:	97524-8606
Country	:	US
Telephone Number	:	541-826-5576
Fax Number	:

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

Provider Enumeration Date	:	08/14/2006
Last Update Date	:	04/08/2008

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