Healthcare Provider Details

I. General information

NPI: 1174662118
Provider Name (Legal Business Name): JEFFREY HANSEN MD
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 02/06/2007
Last Update Date: 05/06/2026
Certification Date: 05/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5121 S COTTONWOOD ST
MURRAY UT
84107-5701
US

IV. Provider business mailing address

5171 S COTTONWOOD ST STE 740
MURRAY UT
84107-5705
US

V. Phone/Fax

Practice location:
  • Phone: 801-507-9700
  • Fax:
Mailing address:
  • Phone: 801-507-9700
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code207Q00000X
TaxonomyFamily Medicine Physician
License Number7330816-1205
License Number StateUT
# 2
Primary TaxonomyY
Taxonomy Code207P00000X
TaxonomyEmergency Medicine Physician
License Number7330816-1205
License Number StateUT

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: