Individual
DR. JASON MATTHEW HANSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
12255 DE PAUL DR STE 830N, BRIDGETON, MO 63044-2510
(314) 291-5307
(314) 291-0838
Mailing address
12255 DE PAUL DR STE 830N, BRIDGETON, MO 63044-2510
(314) 291-5307
(314) 291-0838
Taxonomy
Speciality
Code
Description
License number
State
207Y00000X
Otolaryngology Physician
Primary
103004
MO
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
002013172
PTAN
MO
Enumeration date
08/30/2006
Last updated
03/26/2024
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