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NPI Code Detail

MEDICARE: ERIC H HANSON M.D.

MEDICARE: ERIC H 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
1207SG0202XClinical Biochemical Genetics Physician11465NV
22083A0100XAerospace Medicine Physician11465NV

General Provider Information

NPI Number : 1760460950
Entity Type Code : Individual
Provider Name (Legal Business Name) : ERIC H HANSON M.D.
Provider Business Mailing Address
First Line : PO BOX 400010
Second Line :
City : LAS VEGAS
State : NV
Zip : 89140-0010
Country : US
Telephone Number : 702-478-2424
Fax Number : 702-735-9074
Provider Business Practice Location Address
First Line : 5495 S RAINBOW BLVD STE 102
Second Line :
City : LAS VEGAS
State : NV
Zip : 89118-1872
Country : US
Telephone Number : 702-478-2424
Fax Number : 702-735-9074
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/06/2006
Last Update Date : 08/09/2010

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