MEDICARE: DR. ERIC MORGAN HANSON 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
1	207ND0900X	Dermatopathology Physician	6358587-1205	UT
2	207N00000X	Dermatology Physician	6358587-1205	UT
3	207ND0900X	Dermatopathology Physician	4301085258	MI
4	207ZP0102X	Anatomic Pathology & Clinical Pathology Physician	53576-20	WI
5	207ND0900X	Dermatopathology Physician	53576-20	WI
6	207ZD0900X	Dermatopathology (Pathology) Physician	53576-20	WI

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

General Provider Information

NPI Number	:	1376526095
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. ERIC MORGAN HANSON M.D.

Provider Business Mailing Address
First Line	:	768 S 1600 W STE B
Second Line	:
City	:	MAPLETON
State	:	UT
Zip	:	84664-4563
Country	:	US
Telephone Number	:	801-477-6843
Fax Number	:

Provider Business Practice Location Address
First Line	:	768 S 1600 W STE B
Second Line	:
City	:	MAPLETON
State	:	UT
Zip	:	84664-4563
Country	:	US
Telephone Number	:	801-477-6843
Fax Number	:

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

Provider Enumeration Date	:	11/28/2005
Last Update Date	:	10/16/2025

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