Healthcare Provider Details

I. General information

NPI: 1407846926
Provider Name (Legal Business Name): TIMOTHY SCOTT HANSON MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/26/2005
Last Update Date: 07/26/2024
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

HOPE CLINIC 101 SOONER RD
BARTLESVILLE OK
74003
US

IV. Provider business mailing address

204 BEECHER LANE
BARTLESVILLE OK
74006
US

V. Phone/Fax

Practice location:
  • Phone: 918-440-7692
  • Fax:
Mailing address:
  • Phone: 918-914-4143
  • Fax: 505-923-5354

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License NumberMD2013-0459
License Number StateNM
# 2
Primary TaxonomyY
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number102
License Number StateOK
# 3
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number36684
License Number StateWI

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: