Individual
JEFFREY N HANSEN
Active
Sole proprietor
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
450 MOUNTAIN VIEW ST, POWELL, WY 82435-2212
(307) 754-7257
(307) 754-7217
Mailing address
449 MOUNTAIN VIEW ST, POWELL, WY 82435-2232
(307) 754-4559
(307) 754-7733
Taxonomy
Speciality
Code
Description
License number
State
207X00000X
Orthopaedic Surgery Physician
Primary
7255A
WY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
0153452
MEDICAID
MT
01
—
314166
BLUE CROSS BLUE SHIELD
WY
Enumeration date
05/06/2006
Last updated
07/08/2007
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