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NPI Code Detail

MEDICARE: JOHN PIERRUS HANSON JR. M.D.

MEDICARE: JOHN PIERRUS HANSON JR. 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
1207RH0003XHematology & Oncology Physician17515WI

Other Identifiers

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

General Provider Information

NPI Number : 1275536450
Entity Type Code : Individual
Provider Name (Legal Business Name) : JOHN PIERRUS HANSON JR. M.D.
Provider Business Mailing Address
First Line : 2901 W KINNICKINNIC RIVER PKWY
Second Line : STE 516
City : MILWAUKEE
State : WI
Zip : 53215-3660
Country : US
Telephone Number : 414-385-3086
Fax Number : 414-672-1985
Provider Business Practice Location Address
First Line : 2901 W KINNICKINNIC RIVER PKWY
Second Line : STE 415
City : MILWAUKEE
State : WI
Zip : 53215-3660
Country : US
Telephone Number : 414-385-3086
Fax Number : 414-672-1985
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/23/2005
Last Update Date : 03/17/2008

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