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General NPI Number Information
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NPI Number | 1659363182
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Entity Type | Individual
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Provider Name | CRAIG L HANSEN M.D.
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Gender | Male
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Dates
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Enumeration Date | 08/19/2005
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Last Update Date | 11/04/2024
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Provider Practice Location Address
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Address Line | 1260 VALLEY VIEW DR
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City | COUNCIL BLUFFS
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State | IA
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Zip | 51503-5245
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Country | US
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Telephone | 402-609-3000
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Fax | 402-609-3808
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Provider Business Mailing Address
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Address Line | 1260 VALLEY VIEW DR
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City | COUNCIL BLUFFS
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State | IA
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Zip | 51503-5245
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Country | US
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Telephone | 402-609-3000
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Fax | 402-609-3808
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | 22247
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License Number State | NE
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Taxonomy #2
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Taxonomy Code | 207XS0114X
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Taxonomy Name | Adult Reconstructive Orthopaedic Surgery Physician
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License Number | 22247
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License Number State | NE
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Taxonomy #3
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Taxonomy Code | 207XS0114X
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Taxonomy Name | Adult Reconstructive Orthopaedic Surgery Physician
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License Number | MD-34632
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License Number State | IA
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Taxonomy #4
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Taxonomy Code | 207X00000X
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Taxonomy Name | Orthopaedic Surgery Physician
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License Number | MD-34632
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License Number State | IA
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