Individual
STEPHEN M HANSEN
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
M.D.
Contact information
Practice address
950 HOSPITAL WAY STE A, POCATELLO, ID 83201-2762
(208) 478-4522
(208) 712-6868
Mailing address
950 HOSPITAL WAY STE A, POCATELLO, ID 83201-2762
(208) 478-4522
(208) 712-6868
Taxonomy
Speciality
Code
Description
License number
State
207XS0117X
Orthopaedic Surgery of the Spine Physician
7102972-1205
UT
207XS0117X
Orthopaedic Surgery of the Spine Physician
Primary
M-11666
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
8425670
—
WA
Enumeration date
03/17/2006
Last updated
08/31/2022
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