MEDICARE: JILL R 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	207K00000X	Allergy & Immunology Physician	DR.0067275	CO

General Provider Information

NPI Number	:	1366763807
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JILL R HANSON MD

Provider Business Mailing Address
First Line	:	6031 E WOODMEN RD STE 300
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80923-2624
Country	:	US
Telephone Number	:	719-867-7814
Fax Number	:

Provider Business Practice Location Address
First Line	:	6031 E WOODMEN RD STE 300
Second Line	:
City	:	COLORADO SPRINGS
State	:	CO
Zip	:	80923-2624
Country	:	US
Telephone Number	:	719-867-7800
Fax Number	:	719-867-7899

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

Provider Enumeration Date	:	06/18/2010
Last Update Date	:	09/17/2024

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