Individual
DR. WESLEY ROBERT HANSON
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
MD
Contact information
Practice address
152 HIGHWAY 143, ROAN MOUNTAIN, TN 37687-3002
(423) 772-3276
(423) 772-4816
Mailing address
PO BOX 850, ROGERSVILLE, TN 37857-0850
(423) 772-3276
(423) 772-4816
Taxonomy
Speciality
Code
Description
License number
State
207Q00000X
Family Medicine Physician
Primary
14319
TN
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
2007143
BCBST
TN
05
—
3198461
—
TN
Enumeration date
06/20/2005
Last updated
01/29/2010
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