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Individual

DR. THOMAS S HANSTED

Active
Sole proprietor
No

Provider details

NPI number
Gender
Man
Credential
O.D.

Contact information

Practice address
620 N 9TH ST, BISMARCK, ND 58501-4112
(701) 255-4673
(701) 255-4934
Mailing address
620 N 9TH ST, BISMARCK, ND 58501-4112
(701) 255-4673
(701) 255-4934

Taxonomy

Speciality
Code
Description
License number
State
152W00000X
Optometrist
Primary
555
ND

Other

Other identifiers
Code
Description
Identifier
Issuer
State
01
19458
BLUE CROSS BLUE SHIELD
ND
05
60497
ND
01
860555
BCBS VISION SERVICES
ND
05
9201710
SD
Enumeration date
10/11/2005
Last updated
01/08/2008
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