MEDICARE: DR. DARRIN F. HANSEN 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	174400000X	Specialist	372807-1205	UT
2	208600000X	Surgery Physician	372807-1205	UT

General Provider Information

NPI Number	:	1952417990
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. DARRIN F. HANSEN M.D.

Provider Business Mailing Address
First Line	:	96 E KIMBALLS LN STE 409
Second Line	:
City	:	DRAPER
State	:	UT
Zip	:	84020-5021
Country	:	US
Telephone Number	:	801-523-6177
Fax Number	:	801-660-2492

Provider Business Practice Location Address
First Line	:	96 E KIMBALLS LN STE 409
Second Line	:
City	:	DRAPER
State	:	UT
Zip	:	84020-5021
Country	:	US
Telephone Number	:	801-523-6177
Fax Number	:	801-660-2492

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

Provider Enumeration Date	:	08/22/2006
Last Update Date	:	10/12/2018

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