MEDICARE: TIMOTHY SCOTT 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	MD2013-0459	NM
2	207Q00000X	Family Medicine Physician	102	OK
3	207Q00000X	Family Medicine Physician	36684	WI

General Provider Information

NPI Number	:	1407846926
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	TIMOTHY SCOTT HANSON MD

Provider Business Mailing Address
First Line	:	204 BEECHER LANE
Second Line	:
City	:	BARTLESVILLE
State	:	OK
Zip	:	74006
Country	:	US
Telephone Number	:	918-914-4143
Fax Number	:	505-923-5354

Provider Business Practice Location Address
First Line	:	HOPE CLINIC
Second Line	:	101 SOONER RD
City	:	BARTLESVILLE
State	:	OK
Zip	:	74003
Country	:	US
Telephone Number	:	918-440-7692
Fax Number	:

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

Provider Enumeration Date	:	10/26/2005
Last Update Date	:	07/26/2024

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