Healthcare Provider Details

I. General information

NPI: 1578600565
Provider Name (Legal Business Name): CRAIG EUGENE HANSON M.D.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/31/2007
Last Update Date: 08/25/2025
Certification Date: 08/25/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

208 COLUMBUS ST
HICKSVILLE OH
43526-1250
US

IV. Provider business mailing address

1274 MADISON BLVD
VAN WERT OH
45891-2554
US

V. Phone/Fax

Practice location:
  • Phone: 419-542-6692
  • Fax: 419-542-6685
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number4301057977
License Number StateMI
# 2
Primary TaxonomyN
Taxonomy Code207V00000X
TaxonomyObstetrics & Gynecology Physician
License Number35068533
License Number StateOH
# 3
Primary TaxonomyY
Taxonomy Code207VF0040X
TaxonomyUrogynecology and Reconstructive Pelvic Surgery (Obstetrics & Gynecology) Physician
License Number01053849A
License Number StateIN

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: