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NPI Code Detail

MEDICARE: LORNELL EUGENE HANSEN II MD

MEDICARE: LORNELL EUGENE HANSEN II 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
1207Q00000XFamily Medicine Physician30920IA
2202K00000XPhlebology Physician4768SD
3207Q00000XFamily Medicine Physician51491MN
4207Q00000XFamily Medicine Physician4768SD

General Provider Information

NPI Number : 1881640233
Entity Type Code : Individual
Provider Name (Legal Business Name) : LORNELL EUGENE HANSEN II MD
Provider Business Mailing Address
First Line : 3401 S KELLEY AVE
Second Line :
City : SIOUX FALLS
State : SD
Zip : 57106-6300
Country : US
Telephone Number : 605-274-0217
Fax Number : 605-275-6398
Provider Business Practice Location Address
First Line : 3401 S KELLEY AVE
Second Line :
City : SIOUX FALLS
State : SD
Zip : 57106-6300
Country : US
Telephone Number : 605-274-0217
Fax Number : 605-275-6398
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/26/2006
Last Update Date : 09/29/2021

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