MEDICARE: DAVID H HANSON MD

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	207Q00000X	Family Medicine Physician	21657	IA

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	11205	OTHER	IA	WELLMARK

General Provider Information

NPI Number	:	1033220058
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DAVID H HANSON MD

Provider Business Mailing Address
First Line	:	621 S ILLINOIS AVE
Second Line	:	SUITE 103
City	:	MASON CITY
State	:	IA
Zip	:	50401-5489
Country	:	US
Telephone Number	:	641-494-3041
Fax Number	:	641-494-3059

Provider Business Practice Location Address
First Line	:	101 S TAYLOR AVE
Second Line	:
City	:	MASON CITY
State	:	IA
Zip	:	50401-2849
Country	:	US
Telephone Number	:	641-422-7766
Fax Number	:	641-422-7788

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/31/2006
Last Update Date	:	07/08/2007

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Directions to “ DAVID H HANSON MD” Practice Location

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