Healthcare Provider Details

I. General information

NPI: 1437269263
Provider Name (Legal Business Name): GREGORY SCOTT HANSON M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/30/2006
Last Update Date: 04/22/2021
Certification Date: 03/29/2021
Deactivation Date:
Reactivation Date:

III. Provider practice location address

10 KRUGER RD
PLAINS MT
59859
US

IV. Provider business mailing address

10 KRUGER RD PO BOX 768
PLAINS MT
59859-9506
US

V. Phone/Fax

Practice location:
  • Phone: 406-826-4813
  • Fax: 406-826-4811
Mailing address:
  • Phone: 406-826-4816
  • Fax: 406-826-4989

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number7607
License Number StateMT
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number7607
License Number StateMT
# 3
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number7607
License Number StateMT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: