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NPI Code Detail

MEDICARE: DR. DOUGLAS HANSEN M.D.

MEDICARE: DR. DOUGLAS HANSEN M.D.
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
1207Q00000XFamily Medicine Physician39798CO

Medicare Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
3CO40919OTHERCOMEDICARE PTAN

Other Identifiers

# Provider Identifier Provider Identifier Type Provider Identifier State Provider Identifier Issuer
1MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
239798OTHERCOSTATE LICENSE

General Provider Information

NPI Number : 1184773400
Entity Type Code : Individual
Provider Name (Legal Business Name) : DR. DOUGLAS HANSEN M.D.
Provider Business Mailing Address
First Line : 13402 W COAL MINE AVE
Second Line : SUITE 230
City : LITTLETON
State : CO
Zip : 80127-5407
Country : US
Telephone Number : 303-730-2167
Fax Number :
Provider Business Practice Location Address
First Line : 13402 W COAL MINE AVE
Second Line : SUITE 230
City : LITTLETON
State : CO
Zip : 80127-5407
Country : US
Telephone Number : 303-730-2167
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/09/2007
Last Update Date : 03/07/2023

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Directions to “ DR. DOUGLAS HANSEN M.D.” Practice Location

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