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General NPI Number Information
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NPI Number | 1902845712
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Entity Type | Individual
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Provider Name | DONALD C HANSEN M.D.
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Gender | Male
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Dates
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Enumeration Date | 06/06/2006
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Last Update Date | 01/02/2013
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Provider Practice Location Address
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Address Line | 1299 BERTHA HOWE AVE
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City | MESQUITE
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State | NV
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Zip | 89027-7500
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Country | US
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Telephone | 702-345-4270
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Fax |
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Provider Business Mailing Address
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Address Line | 1235 W RED BUTTE
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City | WASHINGTON
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State | UT
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Zip | 84780-8485
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Country | US
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Telephone |
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Fax |
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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 | 207P00000X
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Taxonomy Name | Emergency Medicine Physician
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License Number | 11882
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License Number State | NV
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