Healthcare Provider Details

I. General information

NPI: 1891777181
Provider Name (Legal Business Name): ALAN S HANSON MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/14/2005
Last Update Date: 01/04/2008
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1601 E 19TH AVE STE 4300
DENVER CO
80218-1216
US

IV. Provider business mailing address

1601 E 19TH AVE STE 4300
DENVER CO
80218-1216
US

V. Phone/Fax

Practice location:
  • Phone: 303-327-4700
  • Fax: 303-327-4711
Mailing address:
  • Phone: 303-327-4700
  • Fax: 303-327-4711

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code207RN0300X
TaxonomyNephrology Physician
License Number28680
License Number StateCO

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: