Healthcare Provider Details

I. General information

NPI: 1083684302
Provider Name (Legal Business Name): CHRISTIAN S HANSON D.O.
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/26/2006
Last Update Date: 03/04/2014
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9228 S MINGO RD SUITE 200
TULSA OK
74133-5718
US

IV. Provider business mailing address

9228 S MINGO RD SUITE 200
TULSA OK
74133-5718
US

V. Phone/Fax

Practice location:
  • Phone: 918-592-0999
  • Fax: 918-878-2499
Mailing address:
  • Phone: 918-592-0999
  • Fax: 918-878-2499

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code174400000X
TaxonomySpecialist
License Number1871
License Number StateOK
# 2
Primary TaxonomyY
Taxonomy Code207RE0101X
TaxonomyEndocrinology, Diabetes & Metabolism Physician
License Number1871
License Number StateOK

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: