MEDICARE: KARL NEAL 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	207QA0505X	Adult Medicine Physician	L017687	LA

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	:	1619971074
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KARL NEAL HANSON MD

Provider Business Mailing Address
First Line	:	200 W ESPLANADE AVE
Second Line	:	STE 307
City	:	KENNER
State	:	LA
Zip	:	70065-2474
Country	:	US
Telephone Number	:	504-467-3404
Fax Number	:	504-467-3244

Provider Business Practice Location Address
First Line	:	200 W ESPLANADE AVE
Second Line	:	STE 307
City	:	KENNER
State	:	LA
Zip	:	70065-2474
Country	:	US
Telephone Number	:	504-467-3404
Fax Number	:	504-467-3244

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

Provider Enumeration Date	:	06/13/2005
Last Update Date	:	01/19/2010

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